• See Also
  1. Head Injury
  2. Management of Severe Head Injury
  • Pathophysiology
  1. Severe Head Injury typically affecting deep brain tissue
    1. Most commonly involves anterior Frontal Lobes (frontal poles) and Temporal Lobes
  2. Deep injury results from tensile and shearing forces
    1. Tears small caliber arterioloes within the brain
    2. Results in small Hemorrhages that may coalesce into larger intraparenchymal Hematomas
    3. Injury may be on the same, ipsilateral side of injury, or contralateral side (contrecoup)
  • Signs
  1. General
    1. Focal neurologic deficits
    2. Prolonged coma
  2. Brainstem Contusion
    1. Decerebrate rigidity
    2. Unequal dilated pupils
    3. Coma
  • Imaging
  1. CT Head (at presention and repeated in 12 hours)
    1. Cerebral Infarction, necrosis and Hemorrhage results in a heterogeneous, irregular appearance to parenchyma
    2. Edema
    3. Intraparenchymal Hemorrhage
  • Management
  1. See Management of Severe Head Injury
  2. Emergent Neurosurgical Consultation
  • Complications
  1. Severe Head Trauma Related Increased Intracranial Pressure
  2. Post-Traumatic Seizure
  3. Focal neurologic deficits (in distribution of Contusion)
  • References
  1. Abuguyan (2024) Crit Dec Emerg Med 38(7): 4-11