![]() ![]() Understanding this mechanism of injury allows one to understand why these parenchymal contusions are frequently located in the brain at the site of or opposite to the site of head impact, the so called “coup” and “contre-coup” pattern of head injury. In the setting of significant force, the brain impacts the adjacent skull with deformation of the underlying brain that results in hemorrhagic parenchymal contusions. Hemorrhagic parenchymal contusions have a predilection for the anterior and posterior temporal lobes, and the inferior frontal lobes, all of which are located adjacent to the bony structures of the skull ( Figure 5). ![]() MRI is more sensitive than CT for the detection of small focal hemorrhagic contusions, especially when volumetric GRE sequences are obtained ( Figure 5). These contusions are characterized on CT as hyperdense hemorrhage within the brain parenchyma itself, and they are caused by microvascular arterial or venous injury. Hemorrhagic parenchymal contusions most commonly occur with significant head motion and head impact. ![]()
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