What tests should be performed for cerebral contusion and laceration?
Nov 25, 2025
Source: Cainiu Health
Dr. Li Yun
Introduction
The evaluation of cerebral contusion and laceration should focus on assessing the condition and identifying the underlying cause. Core diagnostic procedures include cranial CT, cranial MRI, lumbar puncture, cerebral angiography, complete blood count, and biochemical tests. Clinical evaluations should be selected appropriately based on the patient's history of injury and the urgency of symptoms, with priority given to essential emergency examinations. Results should be promptly integrated after testing to comprehensively determine the severity of the condition.
Examination for cerebral contusion and laceration should focus on assessing the condition and identifying its cause. Core diagnostic procedures include cranial CT, cranial MRI, lumbar puncture, cerebral angiography, complete blood count (CBC), and biochemical tests. Detailed analysis is as follows:
1. Cranial CT: As the first-line examination, it enables rapid localization of the injury site and clear delineation of the affected area. Imaging typically shows patchy hyperdense lesions within the brain parenchyma, often accompanied by hypodense regions due to cerebral edema. This test is fast and ideal for emergency settings.
2. Cranial MRI: More sensitive in detecting subtle injuries and white matter abnormalities, making it suitable for subacute or chronic phase patients. It clearly reveals intracranial hematomas and axonal injuries following cerebral contusion and laceration, especially capable of identifying brainstem injuries that may be missed by CT, thus complementing CT findings.
3. Lumbar puncture: Primarily used to measure intracranial pressure and assess for intracranial infection or subarachnoid hemorrhage. Xanthochromic or bloody cerebrospinal fluid (CSF) suggests brain parenchymal injury extending into the subarachnoid space. The procedure must be performed cautiously when intracranial pressure is significantly elevated to avoid triggering brain herniation.
4. Cerebral angiography: Indicated for patients suspected of having associated cerebrovascular injuries, such as intracranial hematoma with vascular malformations or aneurysms. It provides detailed visualization of cerebral vessel morphology, helping confirm vessel rupture, stenosis, or malformation, and offers precise vascular localization for surgical planning.
5. Complete blood count and biochemical tests: Hemoglobin and hematocrit levels help determine whether there is intracranial or systemic blood loss. Monitoring electrolytes, liver and kidney function evaluates the patient’s overall metabolic status and organ function, providing guidance for fluid replacement and medication use during treatment.
Clinical evaluation should integrate the patient's history of trauma and symptom severity to guide appropriate test selection, prioritizing essential emergency assessments. Results should be promptly synthesized to comprehensively evaluate disease severity. Close monitoring of vital signs is essential to lay the foundation for subsequent treatment and rehabilitation.
