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Revision 5 for 'Cerebral haemorrhagic contusion'

Cerebral haemorrhagic contusion

Cerebral haemorrhagic contusions, a type of intracerebral haemorrhage, are common in the setting of significant head injury, and occur in typical locations, both as a result of the direction of head strike and the intrinsic shape of the skull cavity.

floor of the anterior cranial fossa
temporal pole
coup and contrecoup

Contusions typically mature over a number of weeks, initially appearing as merely haemorrhagic foci, followed by the development of surrounding oedema, be fore gradually fading leaving behind more or less obvious areas of gliosis.

Radiographic features

CT

CT is usually the first and often only investigation used to assess cerebral contusions. Typically contusions appear as foci of hyperdensity involving the grey matter and subcortical white matter.

MRI

Although not often used merely for the assessment of superficial contusions, MRI is far more sensitive to small contusions, especially when T2* sequences are used (e.g. gradient echo, SWI)