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