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Brain Contusion: Treatment, Recovery & Long-Term Effects

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Instructor
Kaitlin Baker

Kaitlin has taught nursing students and has a master's degree in nursing leaderhsip, as well as a bachelor's degree in English literature.

Expert Contributor
Christianlly Cena

Christianlly has taught college physics and facilitated laboratory courses. He has a master's degree in Physics and is pursuing his doctorate study.

This lesson will discuss brain contusions - bruises to the brain that cause bleeding or swelling. You will learn about treatment options, recovery therapies, and the outlook and long-term effects of this type of injury. Updated: 01/26/2021

Cerebral Contusion

You know what happens when you get a bruise on your leg? Perhaps you ran into the coffee table and then the next day you notice a tender black and blue mark that slowly turns purple, then yellow, and eventually fades away. Did you know that the same thing can happen in your brain? A bruise in the brain is called a cerebral contusion, or intracerebral hematoma, and like that bruise, this injury can cause swelling and bleeding underneath the skin. Unlike that leg bruise, the treatment, recovery, and long-term effects of a brain contusion can be very serious.

A cerebral contusion is a type of traumatic brain injury (TBI), which is a potentially serious injury since it causes bleeding and swelling in the brain. This usually results from a large impact to the head, but can occasionally result from long-term high blood pressure or a bleeding disorder.

A contusion is different from a concussion, in that concussions are wider-reaching injuries and contusions are more localized in a specific area. Contusions are more serious than concussions because they involve damage to brain structure and pose more severe risks.

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  • 0:00 Cerebral Contusion
  • 1:19 Treatment of Brain Contusion
  • 2:26 Surgical Treatments
  • 3:06 Recovery
  • 4:04 Long-Term Effects
  • 5:01 Lesson Summary
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Treatment of Brain Contusion

Treatment of contusions depends on the extent of the injury. Doctors diagnose contusions and decide on a treatment based on computerized tomography (CT) scans and a physical examination.

If bleeding and swelling in the brain are minor, treatment is conservative. Patients usually stay in the hospital and are observed for up to a week. Treatment may include ice, rest, and pain medications. The patient will need to be monitored for signs of increased intracranial pressure (ICP), pressure inside the skull. There is only a small amount of room for the brain inside the skull, and even a small amount of swelling can cause pressure to increase, potentially causing brain damage. Symptoms of increased ICP include headache, blurred vision, sleepiness, weakness, and vomiting.

If bleeding is severe, patients often are admitted to the intensive care unit (ICU). Treatments may include: supplemental oxygen, mechanical ventilation, pain relief medications, and sedation. Fever and seizures may accompany a severe contusion and are treated as they arise.

Surgical Treatments

If swelling and pressure are especially severe, it is sometimes necessary for patients to have surgery. In these cases, doctors perform a craniotomy, making a 'trap door' in the brain to relieve pressure caused by bleeding or swelling. Another potential surgery is a craniectomy, removing bone from the skull completely to relieve pressure. Craniotomy is any bony opening that is cut into the skull (cranium) to access the brain underneath. Typically the bone flap is replaced. The main difference between the procedures is that, with a craniotomy, the bone flap is replaced. If it is not replaced, the procedure is called a craniectomy.

Recovery

While the tender bruise on your leg may heal in a week or two, recovery after cerebral contusions varies widely. It is possible to have no symptoms at all while recovering from a mild contusion, aside from some minor pain or swelling. Severe injuries can result in numbness or tingling, difficulty with coordinating movements, and problems with speaking, attention, or memory.

During recovery, particularly from a severe injury, doctors will want to monitor ICP. This is measured in two ways:

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Additional Activities

Brain Contusion: Word Scramble Activity

This activity will assess your knowledge regarding the treatment options, therapies, and long-term effects of a brain contusion.

Guidelines

For this activity, study the scrambled letters and unscramble or rearrange the letters to form a word or phrase that fits the given clues. To do this, you must right-click and print this page. With a pencil and an eraser, neatly write your answers in the appropriate spaces in the clues.

Scrambled Words

  1. IEDNGLBE ORDRIESD
  2. SURBDIE AIBRN
  3. OLZEIADCL
  4. OCNROYITAM
  5. RRLIAICAATNN PERSRESU
  6. TRHTCAEE
  7. HACSIYPL PTAYERH
  8. IETLEFMI
  9. EPUMOZDETCRI ROHYMOTPAG
  10. RNOIMTEYCCA

Clues

  1. Traumatic brain injury may result from a __________, which happens when blood lacks certain clotting factors.
  2. Intracerebral hematoma refers to a __________ or a collection of blood within the skull.
  3. A concussion is a mild and __________ brain injury that temporarily affects brain functioning.
  4. __________ is a surgical procedure to relieve pressure in the brain, in which the bone flap is removed, and eventually replaced at the end of the operation.
  5. Severe damage occurs when there is an elevated __________ in the brain.
  6. A __________ is a thin, hollow tube serving a broad range of functions, including the monitoring and measurement of ICP.
  7. Patients recovering from a brain contusion with impaired movement require long-term __________.
  8. Contusions must be given immediate medical attention to prevent adverse outcomes that may last a __________.
  9. __________ is an x-ray imaging technique that creates detailed images of the various organs, including the brain.
  10. __________ is done by completely removing the bone flap from the skull to relieve pressure.


Answer Key

  1. Bleeding disorder
  2. Bruised brain
  3. Localized
  4. Craniotomy
  5. Intracranial pressure
  6. Catheter
  7. Physical therapy
  8. Lifetime
  9. Computerized tomography
  10. Craniectomy

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