Mass lesions of the frontal lobes in acute head injuries. A comparison with temporal lesions.

Abstract

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 lactations 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