الفهرس 
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Abstract
This work was aiming to study the incidence of, and factors affecting the progression of cerebral contusions into intracerebral hemorrhage following traumatic brain injury and hence giving a reliable expectance of hemorrhagic progression of cerebral contusions, the most important factor for surgical decision making.
This study included 40 patients (32 males and 8 females) were scanned initially and cerebral contusion was diagnosed. All of the 40 patients underwent initial cranial CT in the first 4 hours from the time injury. The age for the total sample ranged from 22 years to 60 years, with a mean age of 41 years. The largest group of patients were found in the fourth and fifth decades respectively.
All patients were subjected to the following:
• Full history taking.
• Reviewing of all clinical data, mode of trauma and case progression until arriving at ED.
• CT brain was done for the 40 patients, at the time of presentation, after any clinical deterioration and routinely after 24 to 48 hours.
• Laboratory tests including CBC, coagulation profile and arterial blood gases, at the time of presentation, and serial tests were drawn after 6hours, 12 hours, and 24 hours for HPC cases.
• Clinical, radiological and laboratory findings were correlated simultaneously.
CT brain findings:
Initial cranial CT:
o It was obtained in the first 4 hours after injury.
o All of the studied cases showed variable sizes of cerebral contusions.
o Frontal and parietal lobes were included in the majority of injuries.
Follow-up cranial CT:
o Hemorrhagic progression in 30% of cases.
o No remarkable changes were found in 45% of cases.
o Contusion resolved in 25% of cases.
Laboratory investigations findings:
All initial results were within normal values.
Around half of patients’ results showed coagulopathy.
Around 25% of cases that showed HPC, were associated with coagulopathy.
The results in this study revealed:
CT brain scanning was highly accurate diagnosing cerebral contusions, and intracerebral hemorrhage.
HPC was associated with deterioration of consciousness level.
HPC was found with all grades of TBI (mild, moderate and severe).
Follow-up CCT should be obtained with any deterioration in GCS.
There was a weak relation between HPC and development of coagulation disorders .
HPC had developed at the site of the primary injury, as well as non-contiguous regions.
These results denote that hemorrhagic progression of cerebral contusions can occur with all grades of TBI, and is mostly associated with deterioration in the consciousness level. TBI induces release of some factors, stored in the brain tissue into the circulation, that may results in to coagulopathy.