The course of the traumatising force in acceleration head injury: CT evidence

Be?enski, N.; Broz, R.; Jadro-?antel, D.; Pavic, D.; Mikulic, D.

doi:10.1007/s002340050915

Cited by 5 publications

(5 citation statements)

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“…As the brain deformed in response, stretching in the sagittal plane along the anteriorposterior axis of the brain could produce a contusion in the fronto-parietal cortex. Angular and rotational acceleration are more apt to produce shear strain than linear acceleration given the shape of the brain in the rigid skull [8,[11][12][13]. These forces elicit the contusions in inferior frontal and anterior temporal cortex that are the classic locations of contusions following trauma.…”

Section: Discussionmentioning

confidence: 97%

Isolated lower extremity monoplegia due to a traumatic intraparenchymal contusion: Report of two cases

Lega¹,

Bailey²,

Kramer³

et al. 2010

Brain Injury

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Isolated lower extremity MP following head trauma is rare because haematomas in the fronto-parietal cortex near the midline that could produce such a deficit are rare. The limitations of typical axial CT imaging can be overcome with coronal reconstructions. Practitioners who evaluate patients with isolated MP after head injury should be aware of the possibility of an intraparenchymal lesion near the vertex as the cause of this deficit.

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Section: Discussionmentioning

confidence: 97%

Isolated lower extremity monoplegia due to a traumatic intraparenchymal contusion: Report of two cases

Lega¹,

Bailey²,

Kramer³

et al. 2010

Brain Injury

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“…[6][7][8] Contrecoup lesions have been described as lesions ranging from 90-270 0 , 151-210 0 , and 180 0 from the impact location. [8][9][10][11] While no exact definition has been established,it can be agreed that it is a lesion that is not directly beneath the site of impact and, in this study, contrecoup is defined as the lesion opposite of impact. Two main mechanisms are identified as the the reason behind contrecoup injury in this study, namely cavitation and inertial injury.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Geometric Relation between Cerebral Contusion and Site of Impact in Traumatic Brain Injury Patients

Karima

Kusdiansah

Faried

et al. 2019

mkb

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Cerebral contusion is found in 17-34% of traumatic brain injury (TBI) cases. The inertial and contact effects responsible for this injury makes the presence and location of contusion almost impossible to detect without appropriate imaging techniques. This study aimed to identify the geometric association between site of impact and cerebral contusion in patients with TBI. Data were collected retrospectively from Dr. Hasan Sadikin Hospital Bandung, Indonesia from January 2016-December 2017. TBI patients were scanned for diagnosis of cerebral contusion on the initial CT scan and the presence of soft tissue swelling as the site of impact. The locations were then geometrically classified into four groups; frontal, right temporoparietal, left temporoparietal, and occipital. Analysis was then performed using the multinomial logistic regression method with α=0.05 and 95% confidence interval (CI). Right temporoparietal contusion was associated with contrecoup impact compared to frontal impact (p=0.008, OR 6.8, 95% CI: 1.6-28.7) and occipital impact (p=0.002, OR 6.8, 95% CI: 1.7-26.8) while left temporoparietal contusion was associated with contrecoup impact compared to frontal (p=0.006, OR 6.8, 95% CI: 1.7-26.8) and occipital impact (p=0.016, OR 10, 95% CI: 1.3-17) and with coup impacts compared to frontal impacts (p=0.025, OR 5.3, 95% CI: 1.2-23.3). It is concluded that temporal contusion has a statistically significant correlation with contrecoup impacts. AbstrakKontusi serebral ditemukan pada 17-34% kasus cedera otak traumatika (TBI). Efek inersia dan kontak yang bertanggung jawab untuk cedera ini membuat keberadaan dan lokasi benturan hampir mustahil untuk dideteksi tanpa teknik pencitraan yang tepat. Penelitian ini bertujuan untuk menemukan hubungan geometris antara kontusi serebral dan lokasi benturan yang terjadi pada pasien TBI. Data dikumpulkan secara retrospektif dari Rumah Sakit Dr. Hasan Sadikin Bandung, dari Januari 2016-Desember 2017. Pasien TBI dipindai untuk diagnosis kontusio serebral menggunakan CT scan awal dan adanya pembengkakan jaringan lunak sebagai tempat terjadinya benturan. Lokasi itu kemudian secara geometris diklasifikasikan menjadi empat kelompok; frontal, temporoparietal kanan, temporoparietal kiri, dan oksipital, kemudian dianalisis menggunakan metode regresi logistik multinomial dengan α=0,05 dan interval kepercayaan (IK) 95%. Kontusio temporoparietal kanan dikaitkan dengan impact contrecoup dibanding dengan impact frontal (p=0,008, OR 6,8, IK 95% 1,6-28,7) dan impact oksipital (p=0,002, OR 6,8, IK 95% 1,7-26,8), sementara kontusi temporoparietal kiri dikaitkan dengan impact contrecoup dibandingkan dengan impact frontal (p=0,006, OR 6,8, IK 95% 1,7-26,8) dan impact oksipital (p=0,016, OR 10, IK 95% 1,3-17) dan dengan impact coup dibanding dengan impact frontal (p=0,025, OR 5,3, IK 95% 1.2-23.3). Simpulan, bahwa kontusio temporal memiliki korelasi yang signifikan secara statistik dengan impact contrecoup.

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“…Angular and rotational acceleration tend to generate more shear stress than linear acceleration. [35] Superior frontoparietal cortex contusions are rare and account for up to 4% of cortical contusions. [25]…”

Section: Discussionmentioning

confidence: 99%

Paraplegia caused by cerebral contusions in the bilateral precentral gyri

et al. 2016

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Background:Paraplegia is mainly caused by spinal cord disease and rarely occurs due to head trauma. In this report, we describe a case of paraplegia caused by cerebral contusions in the bilateral precentral gyri.Case Description:A 72-year-old man was admitted to our hospital with mildly impaired consciousness and severe pure motor paralysis in both legs. He was healthy until the morning of the day, but his wife found him injured in front of his house upon returning home. He had a subcutaneous hematoma in his occipital region, and seemed to have slipped by accident. Computed tomography of the brain and magnetic resonance imaging (MRI) of his spinal cord revealed no apparent cause of the paraplegia, although an MRI of his brain clearly revealed cerebral contusions in the bilateral precentral gyri. The cerebral contusion was diagnosed as the cause of pure motor paralysis of lower extremities. He received rehabilitation, and manual muscle testing of his legs revealed improvements. In the subacute phase, the precentral gyrus lesion disappeared on MRI.Conclusion:We must emphasize that cerebral contusion can be a differential diagnosis for paraplegia. In the acute phase, fluid-attenuated inversion recovery (FLAIR) MRI coronal and sagittal images are useful for identifying precentral gyri contusions. Paraplegia caused by a cerebral contusion may be misdiagnosed as a spinal concussion due to the disappearance of the precentral gyrus lesion on FLAIR MRI in the subacute phase.

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The course of the traumatising force in acceleration head injury: CT evidence

Cited by 5 publications

References 0 publications

Isolated lower extremity monoplegia due to a traumatic intraparenchymal contusion: Report of two cases

Isolated lower extremity monoplegia due to a traumatic intraparenchymal contusion: Report of two cases

Analysis of Geometric Relation between Cerebral Contusion and Site of Impact in Traumatic Brain Injury Patients

Paraplegia caused by cerebral contusions in the bilateral precentral gyri

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