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Brain Contusions (Focal Injury) Localized cortical brain bruises Usually visible on CT early Often frontal or temporal Can enlarge over 48–72 hours Cause focal deficits (speech, weakness, personality changes) Diffuse Axonal Injury (Diffuse Injury) Microscopic white-matter injury CT may appear mild MRI required for diagnosis Major cause of prolonged coma Leads to cognitive and consciousness disorders Where they occur: Contusions → cortical surfaces DAI → deep white matter, corpus callosum, brainstem When both coexist, DAI often explains why patients do not wake up even after contusions are treated surgically

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