Fact-sheet: Cerebral contusion
Updated on 04/23/2019 at 9:58 AM
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Definition
Focal superficial cortical lobar lesions, edematous or hemorrhagic, at the site of impact of the head trauma or opposite it as a contrecoup lesion, due to the impact energy not absorbed by the meningeal coverings.
Increases in extent at 48 hours.
They are a source of vasogenic cerebral edema.
CT
Hypodense areas at the site of impact of the trauma or as contrecoup lesions, more frequently frontotemporal, with possible associated hyperdense areas: hemorrhagic edematous contusions.
Management
If the hemorrhagic focus is extensive and compressive, it may result in a mass effect causing intracranial hypertension: decompressive craniotomy required with follow-up CT.
Differential diagnosis
Intraparenchymal hematoma (continuum)
Areas of ischemia with or without hemorrhagic transformation (often suggestive location)
Petechiae (smaller size)