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Created with Fabric.js 1.4.5 CEREBRAL CONTUSION Inside the Forces of a Cerebral Contusion The figure to the left shows how contusions can occur atboth the frontal and occipitallobes of the brain. When a large force is applied to the frontal bone of the skull, it transfers to the cerebro-spinal-fluid, and then the brain. The brain, which is suspended in the CSF, is sent backward and the occipital lobe makes a damaging impact with the occipital bone. These back/forth collisions result in the opposing contusions often observed. Rotational forces may also act on the brain if the collision/impact to the skull isn't linear. Forces to the side of the skull impact the temporal lobes The Symptoms What are Cerebral Contusions? Cerebral contusions are scattered areas of bleeding along the brain's surface. They occur due to traumatic head injury that may cause a more serious hematoma. *Loss of consciousness following extreme head trauma*Cerebral edema within 72 hours of injury*Building of intracranial pressure*Memory loss*Severe headache*Severe nausea*Slurred speech The Diagnosis Cerebral Contusion Treatment A computed tomography (CT) scan is the quickest and most accurate diagnostic method for any injury dealing with intracranial hemorrhaging,such as a cerebral contusion. Other diagnostics might include an MRI or an x-ray for fracture. Complications Any trauma to the brain is immediately serious, and many things could go wrong. This includes:*Tissue ischemia caused by vasocontriction and vessel damage*Subdural/epidural hematoma*Massive intracranial pressure building due to edema*Necrotic neuron death*Hemorrhagic progression of the contusion (hemorrhaging that vastly increases to cause cell necrosis) Prognosis Treatment of a brain injury severe enough to cause a contusion most often includes immediate hospitalization to relieve intracranial pressure. This pressure may be relieved by:*Draining of CSF fluid (allows pressure and edema to subside)*Decompressive craniectomy to form a window(seen in figure below)*Resection of mass lesions Danger also lies in the formation of a thrombus in the cranial arteries, which would have to be surgically removed. After the contusion becomes non-life-threatening, treatments such as ice, rest, and observation will do best for healing. Functional abilities following a cerebral contusion depend upon:*Location of the contusion*Total amount of irreversible tissue injured*Amount of time before medical intervention occurredDepending upon the aforementioned conditions, one may make a full recovery from a cerebral contusion; or, if severe enough, the contusion may cause problems with movement, cognition, consciousness, and even death. Psychological/Emotional Effects A cerebral contusion can lead to a myriad of different emotions for all involved. Because such an injury is always involved with a traumatic event, it may invoke shock in the family of the patient. The patient would most likely be unconscious from severe head trauma. Then, shock may turn to fear as the patient is analyzed and the family finds that it is brain injury. This condition is so sudden that it hardly gives family time to take in all the medical information, so it may be overwhelming and most definitely frightening until, or if, the patient looks to be recovering adequately. Family of Patient Patient If the patient were to lose any motor or cognitive function due to the contusion, he or she would most likely experience anger, frustration, and even depression because they cannot adjust back to their life before injury. Effects on Staff Those immediately treating a patient with a cerebral contusion will be under enormous stress to make sure the patient gets to a non-life-threatening state. However, if the patient goes into a coma or the result is death, the medical staff would experience sadness and possibly regret that more could not be done to help. Physical therapists may also help patients with a cerebral contusion regain mobility lost cognitively. If successful, this process would be very rewarding for the therapist and patient. If the patient is struggling to attain the mobility and life he or she once had, it may be frustrating and disheartening for the therapist and patient as well. The therapist must be able to work through this and encourage the patient so that the best possible results occur.
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