Intraparenchymal injury haematomas and contusions

Intraparenchymal haematomas result from disruption of vascular elements within the brain. They may be focal, as from a penetrating injury, or diffuse from rotational acceleration, which may produce widespread haemorrhage and axonal disruption (Figure 2.1c). Severe diffuse axonal injury may be associated with haemorrhage into the basal ganglia and

Figure 2.1 (b) Patients with an acute subdural haematoma are seen after high speed road traffic accidents, falls, or assaults. They are commonly associated with other parenchymal injuries, which may affect outcome as much as the haematoma itself.

The haematoma often occurs over the temporal pole either from tearing of bridging veins, or from laceration of the brain and disruption of surface arteries. The common combination of temporal lobe laceration and contusion with an associated subdural haematoma is known as "burst temporal lobe"

Figure 2.1 (b) Patients with an acute subdural haematoma are seen after high speed road traffic accidents, falls, or assaults. They are commonly associated with other parenchymal injuries, which may affect outcome as much as the haematoma itself.

The haematoma often occurs over the temporal pole either from tearing of bridging veins, or from laceration of the brain and disruption of surface arteries. The common combination of temporal lobe laceration and contusion with an associated subdural haematoma is known as "burst temporal lobe"

disruption of autoregulation of blood flow. Penetrating injury may be clinically silent, or produce focal neurological deficit, due either to the haematoma or to the underlying neuronal injury. Focal contusions occur both ipsilateral and contralateral to a fracture, as for example bifrontal contusions complicating an occipital fracture. As with subdural haematoma, delayed deterioration may occur in a patient with a brain contusion or intraparenchymal haematoma days after the injury.

Figure 2.1 (c) Intraparenchymal haematomas occur from disruption of vascular elements.

This may be focal from a penetrating injury, or diffuse from rotational acceleration, producing widespread haemorrhage and axonal disruption. Penetrating injury may be clinically silent, or produce focal neurological deficit, due either to the haematoma or the underlying neuronal injury. Focal contusions occur both ipsilateral and contralateral to a fracture, for example, bifrontal contusions complicating an occipital fracture

Figure 2.1 (c) Intraparenchymal haematomas occur from disruption of vascular elements.

This may be focal from a penetrating injury, or diffuse from rotational acceleration, producing widespread haemorrhage and axonal disruption. Penetrating injury may be clinically silent, or produce focal neurological deficit, due either to the haematoma or the underlying neuronal injury. Focal contusions occur both ipsilateral and contralateral to a fracture, for example, bifrontal contusions complicating an occipital fracture

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