Q 2.24. Traumatic Brain Injury. Concussion, brain contusion and brain compression. Traumatic cerebral hemorrhage. Late consequences.

Traumatic Brain Injury (TBI)


Traumatic Brain Injury (TBI) encompasses a range of injuries to the brain caused by external forces. Here’s a summary tailored for medical students, with a focus on brain contusion:

Concussion: A mild form of TBI, typically resulting from a blow to the head, causing temporary neurological dysfunction. Symptoms may include headache, confusion, dizziness, and memory disturbances.

Brain Contusion: A bruise of the brain tissue accompanied by hemorrhage. Clinical symptoms can vary based on the contusion’s location and severity but often include:

  • Loss of consciousness
  • Persistent headache
  • Nausea and vomiting
  • Seizures
  • Difficulty with coordination and movement.

Brain Compression: Occurs when a mass lesion, such as a hematoma, causes increased intracranial pressure, potentially leading to herniation. Symptoms are progressive and may include altered consciousness, pupil dilation, and hemiparesis.

Traumatic Cerebral Hemorrhage: Bleeding within the brain due to vessel rupture, which can be intraparenchymal, subdural, or epidural. Symptoms depend on the hemorrhage’s size and location but can include severe headache, vomiting, seizures, and focal neurological deficits.



  • Immediate Measures: Ensure airway, breathing, and circulation. Assess using the Glasgow Coma Scale. Prevent secondary injury by maintaining cerebral perfusion and oxygenation.
  • Imaging: CT is the primary modality for acute evaluation, while MRI is more sensitive for detecting brain lesions and is used in follow-up.
  • Findings: Imaging may reveal fractures, hemorrhages, contusions, and brain tissue swelling.

Treatment strategies are tailored to the injury’s severity, ranging from rest and symptomatic management for mild cases to surgical intervention for severe injuries. Rehabilitation therapies are crucial for recovery and managing long-term consequences.

Late Consequences: Long-term effects of TBI can range from cognitive deficits, mood alterations, to chronic headaches and post-concussion syndrome.

Understanding Post-Concussion Syndrome:

  • Symptoms: The most common symptoms include persistent headaches, dizziness, fatigue, irritability, anxiety, insomnia, loss of concentration and memory, and noise and light sensitivity.
  • Diagnosis: There is no specific test for PCS. Diagnosis is typically based on the patient’s history and clinical examination. Imaging tests like MRI or CT scans may be used to rule out other conditions.
  • Treatment: Management is individualized and may include medications for pain, rest, gradual return to activities, and cognitive therapy. The focus is on symptom relief and may involve a multidisciplinary approach.

Verified by Dr. Petya Stefanova