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a pathological state that arises as a result of the bruising of the entire body surface or the greater part of it from the effect of a percussion wave or explosion. Contusion may also occur from the fall of large masses of friable bodies, such as sand, gravel, or small stones (during slides), or from water injuries (during an underwater explosion). With contusion there arise general disturbances that occur because of protective inhibition of the central nervous system in response to an extremely strong stimulus to the numerous nerve endings in the skin and soft tissues (reflex fields).
Characteristic of contusion is, first of all, loss of consciousness. Its duration depends on the severity of the contusion and may last from several minutes and hours to days and longer. Along with this, dangerous disturbances of vitally important body functions may occur, such as disturbances of respiration and cardiac activity to the point of coma. The external signs of injury during contusion may be insignificant or completely absent. However, this does not indicate the degree and severity of the contusion, since it is possible that there are at the same time severe injuries to internal organs (liver, kidneys, stomach, etc.), fractures of extremities and ribs, or craniocerebral trauma.
After the return of consciousness, one may note severe headaches, nausea and vomiting (regardless of whether food is taken), dizziness (especially when the head is turned), amnesia, and disturbances of hearing and speech. The most severe disturbances of hearing, even to the point of its complete loss, are possible during barotrauma. The consequences of severe contusion are long-standing rapid fatigability, general malaise, and increased irritability.
Most severe is the course of brain contusion, characteristic of which is the development of general disturbances (loss of consciousness, disturbance of respiration, blood circulation, etc.) and disturbances owing to localization of the focus of affection of the brain tissue. When the contusion focus is localized in the area of the anterior and posterior central gyri of the left temporal lobe of the brain, there arise disturbances of motion and disruptions of sensitivity, speech, hearing, vision, and so on. Brain contusion may be accompanied by hemorrhage and compression of the brain tissue caused by the blood flowing from the blood vessels of the brain, which produces a serious complication— edema of the brain. A consequence of brain contusion may be epileptiform attacks at a later period.
To treat for contusion, patients need complete rest, emergency medical care, and immediate hospitalization. Subsequently, if there are persistent disturbances of motion (pareses, paralyses), therapeutic exercise is prescribed; if there are speech disturbances, logopedic lessons and other special therapeutic measures are prescribed.
I. V. BOGORAD
the mechanical injury of tissues or organs without a break in the skin, usually caused by a blow from a blunt object. The extent of the contusion depends on the size, shape, and weight of the object, the force of the blow, and other factors. The most common contusions are those of the skin, muscles, and periosteum. Contusions are always accompanied by injury to blood vessels and by extravasation into tissues. Ecchymoses occur in superficial contusions, and hematomas are formed with significant extravasation into the soft tissues. Contusions are accompanied by pain, swelling, and, frequently, dysfunction. Contusions of the head may result in concussion and contusion of the brain. Contusions of the rib cage in children may cause contusion of the lungs and heart because the walls of the rib cage are still flexible in children.
Minor contusions are treated with applications of cold compresses and the use of analgesics, with subsequent physical therapy and exercise. Contusions accompanied by injury to internal organs require immediate medical attention and hospitalization.