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Review
. 2021 Feb;34(1):312-324.
doi: 10.1007/s12028-020-00994-4.

Contusion Progression Following Traumatic Brain Injury: A Review of Clinical and Radiological Predictors, and Influence on Outcome

Krishma Adatia  1 , Virginia F J Newcombe  2 , David K Menon  2
Affiliations
Review

Contusion Progression Following Traumatic Brain Injury: A Review of Clinical and Radiological Predictors, and Influence on Outcome

Krishma Adatia et al. Neurocrit Care. 2021 Feb.

Abstract

Secondary injuries remain an important cause of the morbidity and mortality associated with traumatic brain injury (TBI). Progression of cerebral contusions occurs in up to 75% of patients with TBI, and this contributes to subsequent clinical deterioration and requirement for surgical intervention. Despite this, the role of early clinical and radiological factors in predicting contusion progression remains relatively poorly defined due to studies investigating progression of all types of hemorrhagic injuries as a combined cohort. In this review, we summarize data from recent studies on factors which predict contusion progression, and the effect of contusion progression on clinical outcomes.

Keywords: Contusion; Outcome; Predictors; Progression; Traumatic brain injury.

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Conflict of interest statement

Dr. Adatia has nothing to disclose. Dr. Newcombe reports personal fees from Neurodiem, outside the submitted work. Prof. Menon reports grants, personal fees, and non-financial support from GlaxoSmithKline Ltd., grants, personal fees, and other from NeuroTrauma Sciences, grants and personal fees from Integra Life Sciences, personal fees from Pfizer Ltd., grants and personal fees from Lantmannen AB, from Calico Ltd., personal fees from Pressura Neuro Ltd., others from Cortirio Ltd., outside the submitted work.

Figures

Fig. 1
Fig. 1
Mechanism of contusion progression and its clinical and radiological predictors. Kinetic energy delivered to mechanosensitive endothelial cells during impact induces upregulation of specificity protein 1 (Sp1) and nuclear factor-ĸB (NF-ĸB) which, in turn, upregulates sulfonylurea receptor 1 (SUR-1). There is a resultant increase in blood–brain barrier permeability and edema formation, followed by capillary fragmentation and extravasation of blood, i.e., contusion progression
See this image and copyright information in PMC

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