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Mass lesions of the frontal lobes in acute head injuries. A comparison with temporal lesions
Authors:I Papo  G Caruselli  M Scarpelli  A Luongo
Institution:(1) Present address: Neurosurgical Division, General Regional Hospital, Ancona, Italy;(2) Department of Pathology, University of Ancona, Ancona, Italy
Abstract: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 ldquotraumatic intracranial mass lesionsrdquo, 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.
Keywords:Head injuries  frontal contusion  temporal contusion  intracranial hypertension  computer assisted tomography  traumatic intracerebral haematoma
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