Intracerebral Hematoma

Intracerebral hematoama: - Shear induced hemorrhage from rupture of small intraprenchymal blood vessels; - less-associated edema then cortical contusion; - location: frontotemporal white matter and basal ganglia; - Associated: skull fractures; primary neuronal lesions - contusions, DAI, - patients remain lucid after injury, symptoms develop secondary to an expanding hematoma - CT: high density mass oftern within the temporal and frontal lobes - MRI: signal intensity will differ based on age of blood: -- regions of isointense T1 signal represent acute hemorrhage (deoxyhemoglobin) -- Increase T1 signal reflects presence of methemoglobin "Delayed" Intracerebral Hematoma: - Not present on initial posttrauma imaging; - Subsequent intraparenchymal hemorrhage can manifest as clinical deterioration; - Same shear-induced hemorrhage mechanism as  non-delayed hematoma; - Less-associated edema then cortical contusion; - Location: frontotemporal white matter and basal ganglia; - Associated with skull fractures, cortical contusions and DAI Subcortical gray matter injury: - multiple peticial hemorrhages primarily affecting the basal ganglia and thalamus -follows severe head trauma