A cerebral laceration is a type of
traumatic brain injury
A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity (ranging from mild traumatic brain injury TBI/concussionto severe traumatic b ...
that occurs when the tissue of the brain is mechanically cut or torn.
[
] The injury is similar to a
cerebral contusion
Cerebral contusion, Latin ''contusio cerebri'', a form of traumatic brain injury, is a bruise of the brain tissue.
Like bruises in other tissues, cerebral contusion can be associated with multiple microhemorrhages, small blood vessel leaks into ...
; however, according to their respective definitions, the
pia-
arachnoid
Arachnoid may refer to:
* Relating to arachnids
* Arachnoid (astrogeology), a geological structure found only on the planet Venus
* Arachnoid (botany), referring to organs with a cobwebby exterior appearance
* Arachnoid granulation, small protrus ...
membranes are torn over the site of injury in
laceration
A wound is a rapid onset of injury that involves lacerated or punctured skin (an ''open'' wound), or a contusion (a ''closed'' wound) from blunt force trauma or compression. In pathology, a ''wound'' is an acute injury that damages the epiderm ...
and are not torn in
contusion
A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur close ...
.
[
][
] Lacerations require greater physical force to cause than contusions,
but the two types of injury are grouped together in the
ICD-9
The International Classification of Diseases (ICD) is a globally used diagnostic tool for epidemiology, health management and clinical purposes. The ICD is maintained by the World Health Organization (WHO), which is the directing and coordinating ...
and
ICD-10
ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). It contains codes for diseases, signs and symptoms, ...
classification systems.
Signs and symptoms
A fifth of people with cerebral lacerations have a
lucid interval
In emergency medicine, a lucid interval is a temporary improvement in a patient's condition after a traumatic brain injury, after which the condition deteriorates. A lucid interval is especially indicative of an epidural hematoma. An estimated 20 ...
and no significant changes in
level of consciousness
An altered level of consciousness is any measure of arousal other than normal. Level of consciousness (LOC) is a measurement of a person's arousability and responsiveness to stimuli from the environment.
A mildly depressed level of consciousne ...
.
The level of consciousness decreases as the laceration bleeds and blood begins to build up within the skull.
Associated injuries
Cerebral lacerations usually accompany other brain injuries and are often found with skull fractures on both sides of the head.
Frequently occurring in the same areas as contusions, lacerations are particularly common in the inferior
frontal lobe
The frontal lobe is the largest of the four major lobes of the brain in mammals, and is located at the front of each cerebral hemisphere (in front of the parietal lobe and the temporal lobe). It is parted from the parietal lobe by a groove betwe ...
s and the poles of the
temporal lobe
The temporal lobe is one of the four Lobes of the brain, major lobes of the cerebral cortex in the brain of mammals. The temporal lobe is located beneath the lateral fissure on both cerebral hemispheres of the mammalian brain.
The temporal lobe ...
s.
When associated with
diffuse axonal injury
Diffuse axonal injury (DAI) is a brain injury in which scattered lesions occur over a widespread area in white matter tracts as well as grey matter. DAI is one of the most common and devastating types of traumatic brain injury and is a major cause ...
, the
corpus callosum
The corpus callosum (Latin for "tough body"), also callosal commissure, is a wide, thick nerve tract, consisting of a flat bundle of commissural fibers, beneath the cerebral cortex in the brain. The corpus callosum is only found in placental mam ...
and the
brain stem
The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is conti ...
are common locations for laceration.
Lacerations are very common in
penetrating and perforating head trauma and frequently accompany
skull fracture
A skull fracture is a break in one or more of the eight bones that form the cranial portion of the human skull, skull, usually occurring as a result of blunt force trauma. If the force of the impact is excessive, the bone may fracture at or near ...
s; however, they may also occur in the absence of skull fracture.
Lacerations, which may result when brain tissue is stretched, are associated with intraparenchymal bleeding (
bleeding into the brain tissue).
Diagnosis
Prognosis
A cerebral laceration with large amounts of blood apparent on a
CT scan is an indicator of poor
prognosis
Prognosis (Greek: πρόγνωσις "fore-knowing, foreseeing") is a medical term for predicting the likely or expected development of a disease, including whether the signs and symptoms will improve or worsen (and how quickly) or remain stabl ...
.
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
''Mass Effect'' is a military science fiction media franchise created by Casey Hudson, Drew Karpyshyn and Preston Watamaniuk. The franchise depicts a distant future where humanity and several alien civilizations have colonized the known univers ...
it causes.
References
External links
{{neurotrauma
Neurotrauma