Traumatic Intracerebral Hematoma.
- Author:
Hack Gun BAE
1
;
Young Tak PARK
;
Jae Won DO
;
Kyeong Seok LEE
;
II Gyu YUN
;
In Soo LEE
Author Information
1. Department of Neurosurgery, Soonchunhyang University Chunan Hospital, Chunan, Korea.
- Publication Type:Original Article
- Keywords:
Traumatic intracerebral hematoma;
Glasgow coma scale;
Associated lesion;
Time delay;
Suprasellar cistern;
Delayed traumatic intracerebral hematoma;
Outcome;
Follow-up CT scan
- MeSH:
Chungcheongnam-do;
Coma;
Craniocerebral Trauma;
Follow-Up Studies;
Glasgow Coma Scale;
Hematoma*;
Humans;
Mortality;
Prognosis;
Tomography, X-Ray Computed
- From:Journal of Korean Neurosurgical Society
1989;18(4):571-579
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
During a 36-month period, clinical outcome in 170 patients with traumatic intracerebral hematoma(TICH) was analysed. These patients represented 5.1% of 3328 consecutive patients with head injuries admitted to the Soonchunhyang University Chunan Hospital. The overall mortality was 33.5%. A significant number of patients(52.6%), who were not comators at the time of admission(GCS<8), were dead. The factors affecting prognosis were as follows: 1) Glasgow Coma Scale(GCS) on admission(p>0.005) ; 2) the presence of associated lesions(p>0.01) ; 3) time delay of two hours or more from admission to operation(p>0.05) ; 4) actual midline shift of 4.5mm or above on initial CT scan(p>0.005) ; 5) obliteration of suprasellar cistern(p>0.005) ; 6) the presence of delayed traumatic intracerebral hematoma(DTICH) in non-surgical patients with GCS score of 8 or above(p>0.01). Age and location of hematoma did not affect outcome, but the patients with multiple located hematoma showed higher mortality than the others. Time delay in the treatment of TICH and DTICH contribute significantly to poor outocme. Rapidly progressive DTICH within 48 hours after trauma is high in mortality. Follow-up CT scan might as well be performed till 48 hours after injury and 8 hours after initial operation, even though neurological status did not alter for the worse.
