Diagnosing and Treating a Contusion Cerebral - Oren Zarif - Contusion Cerebral
A contusion cerebral is a small, superficial, parenchymal injury to the brain. This type of injury may be a result of coup or contrecoup mechanisms. Most frequently, it is encountered supratentorially and is most common in the frontal and temporal lobes. It may also occur in the cerebellum or in the areas of the skull that are in contact with uneven bone surfaces. Here is a detailed description of the diagnosis and treatment of a cerebral contusion.
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Initial care for a contusion cerebral is centered on a multidisciplinary team that includes the emergency room physician, trauma surgeon, and neurosurgeon. A nurse will monitor vital signs, and the clinical laboratory and blood bank will provide important elements for management decisions. Respiratory therapy will be crucial in managing a ventilator and is coordinated by the neurointensivist. Imaging will be important for assessing damage. Finally, a radiologist will play a key role in monitoring the brain in patients with a cerebral contusion.
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The authors of the current study conducted CT examinations using a unified standard of 5 mm axial thickness. In addition to this, they obtained data on the presence of basal cistern status, third ventricle status, MLS, CT grade of cerebral edema, site of contusion, and mean CT value around the contusion. Overall, these results suggest that CT grading of CC will improve the accuracy of diagnosis in clinical practice.
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There is an important distinction between a focal perfusion deficit in the site of trauma versus diffuse regional hypoperfusion in a patient with a large concussion. While there are distinct differences between focal perfusion deficits and diffuse regional hypoperfusion, they usually occur in the frontal, parietal, and basal ganglia. In some cases, an additional symptom may be present such as cerebellar ataxia.
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MRI is the most widely used imaging method for diagnosing a cerebral contusion. MRI uses radiofrequency waves and a magnetic field to provide a detailed picture of the brain's soft tissues. In addition to the MRI scan, a dye may be injected into the patient's bloodstream to aid in diagnosis. MRI also allows physicians to see subtle changes in the brain and provides a general prognosis.
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A hematoma is a blood clot that forms within the brain. This clot is formed when blood escapes from the normal bloodstream and clots. Hematomas are the body's way of preventing bleeding and can cause pain and other symptoms. Different hematomas develop in different locations of the brain, namely the epidural, subdural, and intracerebral regions. In some cases, the clot is so large that surgery is required to remove it.
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Another study showed that CC with EDH often occurs in patients with a skull fracture or a rich blood supply. These patients may experience space-occupying effects of the brain caused by the CC. Therefore, removing the compression may improve the treatment effect. This study involved patients with CC in the frontal, parietal, temporal, and occipital lobes. While the statistical results showed no significant difference, previous reports indicated inconsistent results.