oa CME : Your SA Journal of CPD - Blunt head injury with diffuse brain damage or diffuse traumatic brain injury - : main article

Volume 24, Issue 3
  • ISSN : 0256-2170



Mechanisms are complex and variable but include acceleration-deceleration and rotation of the head. <BR>The clinical state of concussion / coma is correlative. <BR>The macroscopic stigmata (imaging / autopsy) are haemorrhagic and evanescent, but brain may be macroscopically normal. <BR>The superficial macroscopic lesions are contusions; deep lesions are tissue tears. The microscopic lesions are microhaemorrhages, axonal spheroids and macrophage aggregates; lesions are evanescent. <BR>The distribution of microlesions is variable, with favoured sites, but should be widespread or 'diffuse' in diffuse brain injury. <BR>Diffuse microlesions can occur independently of brain swelling and vice versa. <br>Axonal spheroids are not specific; ischaemia is the commonest cause of these lesions. <BR>CT / MR is diagnostic, with gradient echo an essential technique, especially for follow-up / medico-legal purposes.

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