TRAUMATIC LESIONS AND HEMORRHAGES OR HEMATOMA IN THE BRAIN, DIAGNOSED BY CT. AND MRI.

Abstract

CT and MRI with or without contrast media, are the most convenient and quickest way of investigation to diagnose and demonstrate to the surgeons or physicians, to visualize the lesions in the brain after having traumatic lesions or cerebrovascular accidents.

Hemorrhages and Hematomas may occur in different layers of the skull and brain are:

1. Epidural hematoma: The bleeding or the hematoma is outside the dura, which is thick and tough layer of fibrous tissue sheath covering the brain tissues. The inner outline of the mass or hematoma pressing on the brain will be smooth.

2. Subdural: The bleeding is inside the dura, the pia and arachnoid may be or may be not intact. The outer layer of the lesion will be smooth but the inner layer will be undulating, but not scattering into the brain tissues, if the pia and the arachnoid are intact. 

3. Subarachnoid: The bleeding and hematoma will be scattering freely inside the brain tissues, more on the side with direct trauma. The opposite side will be damaged by “contra coup”.

4. Diffuse axonal injury (DAI): The bleeding go inside the brain along the nerve sheath of the axon.

5. Cortical Contusion or Haemorrhagic Contusion: The hemorrhages are spreading and confined in the cerebral cortex.