What’s a brain contusion?

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Brain contusions, caused by the brain hitting the inside of the skull, can result from sudden impact, such as in accidents or violence. Symptoms range from mild confusion to seizures and vomiting. Treatment depends on severity, and can include medication, surgery, or rest. Complications can include cognitive impairment and nerve damage.

An injury to the brain that occurs without bleeding but causes bruising is known as a brain contusion. Due to the impact created by the brain being bumped into contact with the inside of the skull, a brain contusion can occur due to a variety of situations. Treatment for a brain contusion depends entirely on the severity and location of the injury and can range from simple bed rest to surgery.

Brain contusions generally result from the impact that a sudden and violent accident can trigger. Although the brain is cushioned in its position, any sudden interruption of the surrounding fluid or shaking of the head can cause the brain to momentarily slip out of position and impact the inside of the skull. Individuals who suffer a head injury in an automobile accident, fall, or as a result of an act of violence may develop a brain contusion due to the sudden and forcible arrest of the initial impact causes. Brain contusions, or bruises, are also a common injury sustained in warfare or in the presence of large explosions due to the thrust with which the pressure of the explosion passes through the individual’s head if it is close.

Anyone who suffers a head injury should be seen by a doctor as soon as possible to assess their condition due to the precarious situation that such an injury can entail. Symptoms associated with traumatic brain injury may occur immediately or progress over time, initially presenting as mild but rapidly adopting a more severe presentation. During an initial assessment, the individual may be asked a series of questions and given specific instructions to follow that can assess their cognitive abilities, a standardized testing method known as the Glasgow Coma Scale. A variety of diagnostic tests may also be used to evaluate the individual’s condition, including a computed tomography (CT) scan and magnetic resonance imaging (MRI). If the contusion is suspected to induce swelling, an intracranial pressure monitor may be used to assess the condition of the brain and remove any fluid that may have accumulated at the site of the impact.

Minor brain bruising often causes temporary confusion, headaches, and possibly a momentary loss of consciousness. Other signs of mild trauma may include altered sensory perception, temporary confusion or amnesia, and personality changes. If the initial impact causes swelling, further signs of more serious bruising may include slurred speech, seizures, and persistent nausea, vomiting, and headaches. Although the manifestation of symptoms is generally patterned in its presentation, depending on their age, children who experience a brain contusion may present their symptoms slightly differently. Some may show marked irritability, loss of appetite, or pronounced sleep and behavior changes.

Most mild brain contusions will heal on their own with sufficient rest and the use of an over-the-counter (OTC) pain reliever medication to ease any discomfort. Individuals who have sustained moderate to severe bruising may be placed on additional medications, including diuretics and anticonvulsants, to relieve fluid buildup and reduce the chance of seizures. Individuals who experience significant brain contusion may be purposely put into a coma or undergo surgery and extensive therapy. The presence of a fracture, blood clot, or extensive swelling may also require a surgical procedure to stabilize the individual’s condition and improve their prognosis.

There are significant complications associated with a brain contusion that can impair the individual’s ability to function normally. Those who have sustained significant bruising may develop seizures, cognitive impairment, or nerve damage that results in temporary or permanent paralysis. It has also been argued that those who experience traumatic brain injury may be at increased risk of developing progressive debilitating diseases that affect the nervous system and cognitive function, such as Parkinson’s disease and Alzheimer’s disease.




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