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Cerebral contusion refers to a focal area of brain parenchymal bruising, usually occurring at the cortical surface due to mechanical trauma. It represents intraparenchymal hemorrhage with associated edema and neuronal injury without full-thickness disruption of the cortex.

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It is a common component of traumatic brain injury (TBI), especially in high-impact or deceleration mechanisms.

Etiopathogenesis

Mechanism:

Caused by blunt trauma to the head.
Sudden deceleration leads to the brain striking the inner skull surface—particularly bony ridges (e.g., sphenoid wing, frontal bone).
Coup injury: occurs at the site of impact.
Contrecoup injury: occurs opposite to the site of impact due to rebound movement.

Common sites:

Inferior frontal lobes
Temporal lobes
Occipital lobes (in backward falls)
Posterior fossa (rare, in severe trauma)

Histopathology

Petechial hemorrhages in superficial cortex.
Edema with disruption of microvasculature.
Progresses to necrosis and gliosis.