A cerebral laceration is a type of traumatic brain injury that occurs when the tissue of the brain is mechanically cut or torn.[1] The injury is similar to a cerebral contusion; however, according to their respective definitions, the pia-arachnoid membranes are torn over the site of injury in laceration and are not torn in contusion.[2][3] Lacerations require greater physical force to cause than contusions,[1] but the two types of injury are grouped together in the ICD-9 and ICD-10 classification systems.
Signs and symptoms
A fifth of people with cerebral lacerations have a lucid interval and no significant changes in level of consciousness.[2] The level of consciousness decreases as the laceration bleeds and blood begins to build up within the skull.[2]
Associated injuries
Cerebral lacerations usually accompany other brain injuries and are often found with skull fractures on both sides of the head.[2] Frequently occurring in the same areas as contusions, lacerations are particularly common in the inferior frontal lobes and the poles of the temporal lobes.[1] When associated with diffuse axonal injury, the corpus callosum and the brain stem are common locations for laceration.[1] Lacerations are very common in penetrating and perforating head trauma and frequently accompany skull fractures; however, they may also occur in the absence of skull fracture.[1] Lacerations, which may result when brain tissue is stretched, are associated with intraparenchymal bleeding (bleeding into the brain tissue).[1]
Diagnosis
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Prognosis
A cerebral laceration with large amounts of blood apparent on a CT scan is an indicator of poor prognosis.[2] The progression and course of complications (health effects that result from but are distinct from the injury itself) do not appear to be affected by a cerebral laceration's location or a mass effect it causes.[2]
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Gennarelli GA, Graham DI (2005). "Neuropathology". In Silver JM, McAllister TW, Yudofsky SC (eds.). Textbook Of Traumatic Brain Injury. Washington, DC: American Psychiatric Association. p. 29. ISBN1-58562-105-6. Retrieved 2008-06-10.