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In addition to physical trauma, other types of brain injury, such as stroke, can also produce focal and diffuse injuries.
Diffuse injuries include the following:
Diffuse injuries can result from acceleration/deceleration injuries.
Diffuse injuries, also called multifocal injuries, include brain injury due to hypoxia, meningitis, and damage to blood vessels.
Unlike focal injuries, which are usually easy to detect using imaging, diffuse injuries may be difficult to detect and define; often, much of the damage is microscopic.
Rotational forces are a common cause of diffuse injuries; these forces are common in diffuse injuries such as concussion and diffuse axonal injury.
Coup and contrecoup injuries are considered focal brain injuries, those that occur in a particular spot in the brain, as opposed to diffuse injuries, which occur over a more widespread area.
Forces involving the head striking or being struck by something, termed contact or impact loading, are the cause of most focal injuries, and movement of the brain within the skull, termed noncontact or inertial loading, usually causes diffuse injuries.
Focal injuries are commonly associated with an injury in which the head strikes or is struck by an object; diffuse injuries are more often found in acceleration/deceleration injuries, in which the head does not necessarily contact anything, but brain tissue is damaged because tissue types with varying densities accelerate at different rates.