MANAGEMENT OF TRAUMATIC BRAIN CONTUSIONS

Abstract

Head injury is a modern sourge of industrialized society. It is a major cause of death, especially in young adults and a major cause of disability. Brain injuries occur at all ages, but the peak is in young adults between the age of 15 and 24 years (Mayer and Rowland; 2000). Brain contusions are the classic and .pnmary hallmark of brain trauma. However, they may be totally absent in patients who have sustained severe and even lethal closed Head injury (Adams; 1992). Cerebral contusion IS a pathologic term that implies loss of integrity of the cerebral tissues, usually without interruption of the physical continuity of the cerebral cortex or pia. Contusions are usually found where the dura is not perforated or lacerated. Minor hemorrhages that accompany contusions result from torn or ruptured mterioles, capillaries or veins (Zee, eta!; 1996).

The symptoms and signs of brain contusion in head injured patients will vary according to the site and size of the area of contusion and type of associated lesions, small contusions pose no threat to the patients' life, and may have no symptoms, while larger contusions involving both the ,--- frontal and the temporal lobes• can cause elevations of intracranial pressure, shift of the midline and concomitant coma (Samudrala and Cooper; 1996).