Head injuries due to falls, collisions, or accidents are a great burden, representing some of the most significant causes of hospitalizations and deaths.Among the most common of suchtraumatic brain injuries (TBIs)areconcussionsand cerebral contusions (also known as intracerebral hematoma), a bruising and bleeding of the brain.
While these can be related—and both involve damage to structures of the brain—there are also key differences. Concussion refers to cases of loss of awareness following head injury, whereas cerebral contusion refers specifically to bruising in the brain. Both can result from immediate trauma to the brain, but the latter may also arise due to fracture or can happen without trauma as a cause.
Regardless of the type, TBIs need to be taken seriously. Inflammation and bleeding in the brain associated with both cerebral contusions and concussions can be permanently disabling or even fatal.While these can coexist, just because you have one doesn’t mean you have the other. It’s important to understand how these two conditions are similar and what differentiates them.
Verywell / Brianna Gilmartin
What Is a Cerebral Contusion?
Cerebral contusion refers to bruising and bleeding in the brain, typically arising in areas where the cerebral cortex of the brain strikes the skull or dura mater, the tough membrane surrounding the brain and spinal cord.These contusions can arise in any part of the brain, though certain areas—because of their location—are particularly likely to be affected.
The three types most commonly seen are:
What Is a Concussion?
Concussion is a mild traumatic brain injury that, like most contusions, arises from a blow to the head, which can be inflicted due to a fall, sports injury, or accident. Essentially, the brain twists within the skull and hits the sides.This impact is relatively more diffuse, causing nerves and arteries in the head to become stretched and damaged, and there can be longer-term chemical changes.
Although there is some debate about it, concussions are typically classified based on severity, with the amount of time unconscious and the presence of confusion being considered as the defining features:
How Long Do Concussion Symptoms Last? Key Signs to Watch For
How Do They Compare?
Both concussions and contusions are considered forms of traumatic brain injury, and while some features of the two are shared, there are key differences:
Signs and Symptoms
While both cerebral contusion and concussion can share causes—with some symptoms overlapping—there are significant differences in the way the conditions present. Understanding these is essential for both identification and management of these TBIs.
Contusion
The principle symptoms of cerebral contusion arise due to the direct impact of any trauma, as well as subsequent bleeding and swelling, which increases intracranial pressure (pressure inside the skull). Most cases lead to some loss of consciousness, with symptoms arising within 48 to 72 hours of the incident. Patients experience this as:
Contusions cause symptoms due to the swelling and pooling of blood it’s associated with. These conditions cause significant damage to brain structures and can be fatal if untreated. Here’s a breakdown of what can happen:
Concussion
The symptoms of concussion are more wide-ranging. Some symptoms arise within moments of the injury, but others take a couple hours to emerge. Common symptoms include:
Among the populations that most frequently have concussion are young children and toddlers. Parents should keep an eye out for:
In some cases, concussion can lead to longer-term or chronic symptoms, a condition called post-concussive syndrome (PCS). Symptoms of PCS outlast those of primary concussion and include:
When to Seek Emergency CareIn general, both concussion and contusion warrant emergency care. What are some signs you should call 911? Here’s a breakdown:Any kind of visible cut or lacerationLoss of consciousness for any durationSleepiness and confusion following the traumaSeizure, vomiting, and severe headacheNumbness of the limbsInability to recognize facesLoss of balanceSpeaking, hearing, and vision problems
When to Seek Emergency Care
In general, both concussion and contusion warrant emergency care. What are some signs you should call 911? Here’s a breakdown:Any kind of visible cut or lacerationLoss of consciousness for any durationSleepiness and confusion following the traumaSeizure, vomiting, and severe headacheNumbness of the limbsInability to recognize facesLoss of balanceSpeaking, hearing, and vision problems
In general, both concussion and contusion warrant emergency care. What are some signs you should call 911? Here’s a breakdown:
Causes
Concussions and most cerebral contusions are the result of contact or blows to the head. They can also arise due to sudden whipping of the head. They occur to people of all ages, but are most often seen in young children, adolescents, and those over 75.
According to the Centers for Disease Control and Prevention (CDC), the most frequent causes of these and other TBIs are:
Notably, in addition to physical injury to the head—which can cause skull fractures, blood clots, and pooling of blood (as in subdural and epidural hematoma)—some cases of cerebral contusion arise without trauma. Bleeding disorders in children, longstandinghigh blood pressureamong older adults, certain medications, as well as some illegal drugs also cause it.
Diagnosis
Diagnosing TBIs like concussion and cerebral contusion is a combination of symptom assessment, physical and mental testing, as well as imaging. Getting a full picture of the scale and severity of the injury often requires multiple stages. Tests and approaches that may be used include:
Treatment
The specific management and treatment approaches taken depend on the scale and severity of the TBI. Common approaches include:
While TBIs can be difficult to manage, advances in technologies and techniques have improved outcomes.
Prevention
Put simply, the key to preventing contusions or concussions is to protect your head from injury. Approaches to the prevention of TBI include:
Frequently Asked Questions
Which is more severe—a concussion or a contusion?
Whereas cerebral contusions refer specifically to bruising of the brain, concussions are defined as head injuries resulting in changes in or loss of consciousness. While both concussions and contusions can be fatal or cause permanent changes, concussions tend to lead to a greater range of symptoms and take longer to recover from.
How can you tell the difference between a concussion and a contusion?
Concussions impact multiple parts of the brain, while contusions are localized in one area.The only way to really know whether you have one, the other, or both, is through medical testing and evaluation. Make sure to seek medical attention if you suspect a TBI.
However, there are some ways that the two conditions present differently, including:
How do the signs of contusion differ from those of a concussion?
While the signs of contusion and concussion overlap—especially as they become more severe—there are key differences. Contusion symptomsthat aren’t usually shared with concussion include:
Some other contusion symptoms, however, like memory problems and changes in personality, are also seen in moderate and severe concussions.
A Word From Verywell
Ultimately, TBIs like concussion and cerebral contusion are a consistent and common medical problem. In 2019, this type of injury was the cause of nearly 61,000 deaths in the United States.
It’s therefore critical that you seek immediate medical attention following any kind of blow or impact to the head. Further, remember that your doctor and medical team are there to help; check in with them whenever you have questions or concerns regarding TBI.
While there are certainly challenges when it comes to TBIs, it’s important to note that outcomes have improved as awareness of these conditions has grown and treatments have evolved. Recovery can be challenging; however, concussion and cerebral contusion can be properly and effectively managed.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Head injury.Cedars-Sinai.Head injury.Centers for Disease Control and Prevention.Get the facts about TBI.Weerakkody Y, Gaillard F.Cerebral hemorrhagic contusion. Radiopaedia.Family Practice Notebook.Concussion grading.Physopedia.Classification of traumatic brain injury.Cleveland Clinic.Concussion: causes, symptoms, diagnosis, treatments, prevention.RadiologyInfo.org.Head injury.Shah S, Kimberly W.Today’s approach to treating brain swelling in the neuro intensive care unit.Semin Neurol. 2016;36(06):502-507. doi:10.1055/s-0036-1592109Cleveland Clinic.Subdural hematoma: types, symptoms treatments, prevention.National Institutes of Health.How do healthcare providers diagnose traumatic brain injury (TBI)?National Institutes of Health.What are the treatments for traumatic brain injury (TBI)?
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Johns Hopkins Medicine.Head injury.Cedars-Sinai.Head injury.Centers for Disease Control and Prevention.Get the facts about TBI.Weerakkody Y, Gaillard F.Cerebral hemorrhagic contusion. Radiopaedia.Family Practice Notebook.Concussion grading.Physopedia.Classification of traumatic brain injury.Cleveland Clinic.Concussion: causes, symptoms, diagnosis, treatments, prevention.RadiologyInfo.org.Head injury.Shah S, Kimberly W.Today’s approach to treating brain swelling in the neuro intensive care unit.Semin Neurol. 2016;36(06):502-507. doi:10.1055/s-0036-1592109Cleveland Clinic.Subdural hematoma: types, symptoms treatments, prevention.National Institutes of Health.How do healthcare providers diagnose traumatic brain injury (TBI)?National Institutes of Health.What are the treatments for traumatic brain injury (TBI)?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Johns Hopkins Medicine.Head injury.Cedars-Sinai.Head injury.Centers for Disease Control and Prevention.Get the facts about TBI.Weerakkody Y, Gaillard F.Cerebral hemorrhagic contusion. Radiopaedia.Family Practice Notebook.Concussion grading.Physopedia.Classification of traumatic brain injury.Cleveland Clinic.Concussion: causes, symptoms, diagnosis, treatments, prevention.RadiologyInfo.org.Head injury.Shah S, Kimberly W.Today’s approach to treating brain swelling in the neuro intensive care unit.Semin Neurol. 2016;36(06):502-507. doi:10.1055/s-0036-1592109Cleveland Clinic.Subdural hematoma: types, symptoms treatments, prevention.National Institutes of Health.How do healthcare providers diagnose traumatic brain injury (TBI)?National Institutes of Health.What are the treatments for traumatic brain injury (TBI)?
Johns Hopkins Medicine.Head injury.
Cedars-Sinai.Head injury.
Centers for Disease Control and Prevention.Get the facts about TBI.
Weerakkody Y, Gaillard F.Cerebral hemorrhagic contusion. Radiopaedia.
Family Practice Notebook.Concussion grading.
Physopedia.Classification of traumatic brain injury.
Cleveland Clinic.Concussion: causes, symptoms, diagnosis, treatments, prevention.
RadiologyInfo.org.Head injury.
Shah S, Kimberly W.Today’s approach to treating brain swelling in the neuro intensive care unit.Semin Neurol. 2016;36(06):502-507. doi:10.1055/s-0036-1592109
Cleveland Clinic.Subdural hematoma: types, symptoms treatments, prevention.
National Institutes of Health.How do healthcare providers diagnose traumatic brain injury (TBI)?
National Institutes of Health.What are the treatments for traumatic brain injury (TBI)?
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