Involve crests of gyri and extend into white matter as wedge-
shaped lesions. Most common locations: frontal and temporal
poles. Not usually seeen in infants: instead see lacerations.
Coup: at site of impact Contrecoup: opposite side of impact
(assoc w/falls). Often more severe than the coup. Fracture
contusions: may be displaced from point of impact, underlying
fracture line. Intermediary coup contusions: in white matter,
basal ganglia, corpus callosum or brainstem along line of
impact. Gliding: dorsal cortex and white matter, mostly frontal,
usu assoc w/DAI. Independent of site and direction of impact.
Herniation: at uncus or tonsils, also independent of site and
direction of impact. |LACERATIONS AND PENETRATING WOUNDS Lacs of
corpus callosum or septum pellucidum can occur without skull
fracture (usu younger individuals). Lacs often blood-less due to
vasospasm. Hyperextension injury: lacs to brainstem esp at
ponto-medullary junction, Primarily impact injuries. 90-95%
assoc w/fracture. Rare in very old and ve