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Focal Brain Injury Versus Diffuse Injury

Focal Brain Injury

Diffuse versus Focal Injury

“Contact phenomenon”, typically result in what is called a “focal” brain injury as opposed to a “diffuse” brain injury. In other terms, a blow to the head or the head coming into contact with another item with force.

The term “diffuse” is used to describe the situation where the pathology is spread throughout the brain. A diffuse injury may not be an obvious injury unless proper tests are performed to determine brain injury.  With pathology I mean the cells involved in brain injury either being damaged or torn.  This can cause a spiraling effect such as hematomas or brain bleeds. And in turn cause brain swelling.

Focal Brain Injury:

Focal brain injury are typically large enough that they can be identified “macroscopically” (meaning without the use of a microscope) and diffuse injuries are typically microscopic. For example a focal brain injury would be noticed by an obvious gash on the head, abrasion or bruises.  This would get immediate attention and proper tests would be ordered.  A diffuse injury could go unnoticed and proper tests may not get ordered unless there are other symptoms that make the emergency personnel aware of head trauma.

Impact Phenomenon can result in the following focal injuries:

  • Contusions on the surface of the brain;
  • Hematoma, (a localized area of blood as a result of vessel leakage or bleeding);
    • Epidural (above the dura – a collection of blood between the dura and the skull);
    • Subdural (below the dura – a collection of blood between the dura and the brain);
    • Intracerebral (a collection of blood within the brain.)
    • The dura is the protective sheath around the brain, between the brain and the skull
  • Hemorrhage;
    • Epidural,
    • subdural
    • or intracerebral.
  • Edema; Excessive water accumulation resulting in swelling.
Diffuse Brain Injuries