Summary
Contusions and lacerations of the frontal lobes are very frequent; 43.4% in the whole series of traumatic brain mass lesions. Clinical, ICP, CT scan data and neuropathological findings in patients with such lesions are analysed and correlated. Moreover, the clinical features and the outcome of frontal masses undergoing surgery are also compared with similar lesions located in the temporal lobes.
Frontal lesions cannot be differentiated on purely clinical grounds and the factors governing the outcome in both locations are the same. On the whole, surgical indications nowadays seem to be rather rare; only lesions behaving truly as expanding lesions with obvious intracranial hypertension benefiting from surgery.
Brain contusion-laceration syndromes in general can no longer be considered separate entities. Neither should they be included in the miscellaneous group of “traumatic intracranial mass lesions”, since the pathophysiological significance of purely extracerebral effusions is entirely different.
Traumatic contusions and lacerations and/or intracerebral haematomas, whether frontal or located elsewhere, should, instead, be considered in the context of head injuries of a different degree of gravity, as having collateral features which, on occasion, may call for surgical management.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Adams, J. H., Mitchell, D. E., Graham, D. I., Doyle, D., Diffuse brain damage of immediate impact type. Its relationship to “primary brain-stem damage” in head injuries. Brain100 (1977), 489–502.
Bousigue, J. Y., La tomodensitométrie en pathologie cranio-cérébrale traumatique. Thèse, Toulouse (1979), pp. 102.
Casella, E., Chiappetta, F., Chiasserini, A., Gazzeri, G., Considerazioni statistico-cliniche su 150 casi di lacerazione cerebrale. Minerva Neurochir.11 (1967), 154–157.
Clark, J. M., Distribution of microglial clusters in the brain after head injuries. J. Neurol. Neurosurg. Psychiat.37 (1974), 463–474.
Chodkievicz, J. P., Creissard, P., Redondo, A., Vedrenne, C., Etude anatomoclinique de 150 traumatisés cranio-encéphaliques. Neuro-Chirurgie18 (1972), 77–84.
Cohadon, F., Richer, E., Castel, J. P., Leifer, L., Lean, P., Caille, J. M., Piton, J., Montagac, M., Broussin, J., Aspects cliniques et angiographiques des lésions parenchymateuses fronto-temporales d'origine traumatique. Neuro-Chirurgie19 (1973), 417–430.
Denny-Brown, D., Russell, W. R., Experimental cerebral concussion. Brain64 (1941), 93–164.
Denny-Brown, D., Brain trauma and concussion. Arch. Neurol. (Chicago)5 (1961), 1–3.
Espagno, Ch., La souffrance axiale du traumatisme cranien grave. Thèse, Toulouse (1977), pp. 158.
Espagno, Ch., Tremoulet, M., Gigaud, M., Bousigues, J. Y., Espagno, J., Repercussion axiale des lésions supratentorielles post-traumatiques. Neuro-Chirurgie25 (1979), 206–208.
Gurdjian, E. S., Recent advances in the study of the mechanism of impact injury of the head—a summary. Clin. Neurosurg.19 (1972), 1–42.
Gurdjian, E. S., Lissner, H. R., Evans, F. G., Patrick, L. M., Hardy, W. G., Mechanism of head injury as studied by the cathode ray oscilloscope. J. Neurosurg.1 (1944), 393–399.
Gurdjian, E. S., Lissner, H. R., Webster, J. E., Latimer, F. R., Haddad, B. F., Studies on experimental concussion. Relation of psychological effect to time duration of intracranial pressure increase at impact. Neurology (Minneapolis)4 (1954), 674–681.
Gurdjian, E. S., Webster, J. E., Experimental head injury with special reference to the mechanical factors in acute trauma. Surg. Gynec. Obstet.76 (1943), 623–634.
Gurdjian, E. S., Webster, J. E., Lissner, H. R., Observations on the mechanism of brain concussion, contusion and laceration. Surg. Gynec. Obstet.76 (1955), 680–690.
Hamel, E., Karimi-Nejad, A., Traumatic intracerebral hematomas. In: Advances in neurosurgery 5 (Frowein, R. A., Wilcke, O., Karimi-Nejad, A., Brock, M., Klinger, M., eds.), pp. 56–61. Berlin-Heidelberg-New York: Springer. 1978.
Heiskanen, D., Vapalahti, M., Temporal lobe contusion and hematoma. Acta neurochir. (Wien)27 (1972), 29–35.
Holbourn, A. H. S., Mechanics of head injuries. Lancet2 (1943), 438–441.
Holbourn, A. H. S., The mechanics of brain injuries. Brit. Med. Bull.3 (1945), 147–149.
Lanksch, W., Grumme, Th., Kazner, E., Computed tomography in head injuries, pp. 141. Berlin-Heidelberg-New York: Springer. 1979.
McLaurin, B. L., Helmer, H., The syndrome of temporal lobe contusion. J. Neurosurg.23 (1965), 296–303.
Nevin, N. C., Neuropathological changes in the white matter following head injury. J. Neuropath. Exp. Neurol.26 (1967), 77–84.
Ommaya, A. K., Corrao, P., Pathologic biomechanics of central nervous system injury in head impact and whiplash trauma. In: Brinkhaus, K. M.: Accident pathology, pp. 160–181. Washington D.C.: US Government Printing Office. 1971.
Ommaya, A. K., Gennarelli, T. A., Cerebral concussion and traumatic unconsciousness. Correlation of experimental and clinical observations on blunt head injuries. Brain97 (1974), 633–654.
Ommaya, A. K., Rockoff, S. D., Baldwin, M., Experimental concussion: a first report. J. Neurosurg.21 (1964), 249–264.
Oppenheimer, D. R., Microscopic lesions in the brain following head injury. J. Neurol. Neurosurg. Psychiat.31 (1968), 299–306.
Papo, I., Caneschi, S., Considerazioni sul trattamento chirurgico dei focolai lacero-contusivi traumatici. Minerva Neurochir.8 (1964), 86–88.
Papo, I., Caruselli, G., Luongo, A., CSF withdrawal for the treatment of intracranial hypertension in acute head injuries. Acta neurochir. (Wien)56 (1981), 191–199.
Papo, I., Caruselli, G., Luongo, A., Scarpelli, M., Pasquini, U., Traumatic intracerebral mass lesions: correlations between clinical, intracranial pressure and computed tomographic data. Neurosurgery7 (1980), 337–346.
Pudenz, R. H., Shelden, C. H., The lucite calvarium—a new method for direct observation of the brain. II. Cranial trauma and brain movement. J. Neurosurg.31 (1946), 487–505.
Rowbotham, G. F., Acute injuries of the head, pp. 584. Edinburgh: Livingstone. 1964.
Snoek, J., Jennett, B., Adams, J. H., Graham, D. I., Doyle, D., Computerized tomography after recent severe head injury in patients without acute intracranial hematoma. J. Neurol. Neurosurg. Psychiat.42 (1979), 215–225.
Stritch, S. J., The pathology of brain damage due to blunt head injuries. In: The late effects of head injury (Walker, E. A., Caveness, W. F., Critchley, M., eds.), pp. 501–526. Springfield, Ill.: Ch. C Thomas. 1969.
Stritch, S. J., Shearing of nerve fibres as a cause of brain damage due to head injury. A pathological study of twenty cases. Lancet2 (1961), 443–448.
Stritch, S. J., Diffuse degeneration of the cerebral white matter in severe dementia following head injury. J. Neurol. Neurosurg. Psychiat.19 (1956), 163–185.
Teasdale, G., Jennett, B., Assessment of coma and impaired consciousness. Lancetii (1974), 81–84.
Torres, H., Mirabile, J., Ferguson, L., Temporal lobe contusions. Neurochirurgia (Stuttgart)15 (1972), 62–69.
Unterharnscheidt, F. J., Higgins, L. S., Neuropathologic effects of rotational and translational accelerations of the head in animal experiments. In: The late effect of head injury (Walker, E. A., Caveness, W. F., Critchley, M., eds.), pp. 158–167. Springfield, Ill.: Ch. C Thomas. 1969.
Vigouroux, R. P., Guillermain, P., Effects of therapy on prognosis of cerebral contusions. Acta neurochir. (Wien) Suppl.28 (1979), 209.
Vigouroux, R. P., Guillermain, P., Posttraumatic hemispheric contusion and laceration. Progress. Neurol. Surg. 10, pp. 49–163. Basel: Karger. 1981.
Weigel, K., Ostertag, C. H., Mundinger, F., Follow-up control after traumatic intracerebral hemorrhage. In: Advances in Neurosurgery 5 (Frowein, R. A., Wilcke, O., Karimi Nejad, A., Brock, M., Klinger, M., eds.), pp. 62–67. Berlin-Heidelberg-New York: Springer. 1978.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Papo, I., Caruselli, G., Scarpelli, M. et al. Mass lesions of the frontal lobes in acute head injuries. A comparison with temporal lesions. Acta neurochir 62, 47–72 (1982). https://doi.org/10.1007/BF01402210
Issue Date:
DOI: https://doi.org/10.1007/BF01402210