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Contusional brain injury and intracerebral haemorrhage
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Acute contusions typically occur over the crests of the gyri and have a conical appearance with the widest part in the superficial position and the apex deeper (Figure 10.1). They have a red or red-purple appearance when fresh. Larger contusions extend into white matter and can give rise to significant ICH. There is usually associated subarachnoid haemorrhage. Complications such as burst lobe and delayed ICH may occur (see later). Old contusions appear gold-brown (Figure 10.2). They are not infrequently seen as an incidental finding.
The nervous system and the eye
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
James A.R. Nicoll, William Stewart, Fiona Roberts
Intracerebral haematomas tend to be associated with contusions and occur principally in the frontal or temporal lobes. The term ‘burst lobe’ is used to describe the combination of an intracerebral haematoma in continuity with a subdural haematoma through surface contusions. Small, deeply seated intracerebral haematomas – often referred to as ‘basal ganglia haematomas’ – also occur and have a higher incidence in patients with diffuse traumatic axonal injury (see below).
Biomechanics and Tissue Injuries
Published in Rolland S. Parker, Concussive Brain Trauma, 2016
Severe injury or a site confluent with other contused areas causes blood to displace the parenchyma, forming an intracerebral hematoma. Replacement of an entire lobe by blood is called a burst lobe (Britt & Heiserman, 2000). One may differentiate between coup, contrecoup, and herniation contusions (the medial parts of the temporal lobe impact against the edge of the tentorium; cerebellar tonsil impacts against the foramen magnum). Surface contusions are differentiated from gliding contusions (i.e., focal hemorrhages in the cortex and subjacent white matter of the superior margins of the cerebral hemispheres [common in DAI]). The pia-arachnoid is intact over contusions but torn in lacerations. Their hemorrhagic, swollen state evolves into shrunken brown scars.
Diagnostic value of lateral ventricle ratio: a retrospective case-control study of 112 acute subdural hematomas after non-severe traumatic brain injury
Published in Brain Injury, 2019
Ernest J. Bobeff, Jan Fortuniak, Katarzyna Ł. Bobeff, Karol Wiśniewski, Rafał Wójcik, Ludomir Stefańczyk, Dariusz J. Jaskólski
The term “intracerebral hemorrhage” encompasses a number of entities that share the acute accumulation of blood in the parenchyma of the brain. In our study we defined it as intracranial bleed that occurs within the brain tissue and constitute a compact mass, as distinct from “cerebral contusion” characteristic of multiple microhemorrhages or “burst lobe” occurring in continuity with a subdural hemorrhage.