Cerebral Contusion and Cerebral Concussion
Cerebral concussion is the most common phenomenon seen after trauma to the head resulting from changes within the brain. This is defined as a transient state of neuronal dysfunction induced by trauma and occurs immediately. There could be amnesia for the moment of the accident and for a variable period prior to the accident. The theory to this could be that the shearing forces to which the brain is subjected that induce stretching, compression and tearing of nerve fibers.
In my practice, i have seen many cases of cerebral concussion brought about by fall. The children may have vomiting with no loss of consciousness. After how many minutes, they are already up and about as if nothing had happened. I usually instruct the parents to do close observation and to come back for follow up if the child will have persistent vomiting, headache and sleepiness for further work up.
Cerebral contusion is a more serious head injury which induces gross or microscopic hemorrhages in the brain. Contusions may appear in the superficial areas of the brain at the site of injury or the opposite side. The commonly contused areas of the brain are the orbital surfaces of the frontal lobes and the inferolateral aspects of the temporal lobes. These lacerations are usually associated with depressed skull fractures or penetrating wounds, although they can occur without fractures.
Cerebral edema may also occur following head injury. This could be due to a temporary impairment of water and electrolyte permeability and transport mechanism. Edema may then result to vascular stasis, anoxia and further vasodilatation. When this edema is big enough, herniation of the brain may occur resulting in death.