How Are Brain Contusions Different from Brain Concussions?

For a problem as pervasive as traumatic brain injury one would think that the different forms it can take would be widely known and understood. However, in my practice of community-based neurology I find this is not the case. Patients and their families are seldom familiar with the concepts of cerebral (brain) contusion and concussion, and a common error is to believe that they are basically the same, except that a contusion is a more severe form of a concussion.

Before exploring the differences between these two terms, let’s first acknowledge how they are alike:

* Both are due to head trauma.
* Both are common.
* Both are serious.

But that’s where the similarities end. The differences between cerebral contusions and concussions can be boiled down to two basic concepts:

* Contusions are localized, while concussions are widespread.
* Contusions are macroscopic, while concussions are microscopic.

To flesh out these concepts more fully we’ll need to discuss brain anatomy, brain physiology and brain-imaging technologies.

A contusion is a bruise. At one time or another everyone has bruised himself or...