A prospectively study were conducted in 77 cases of delayed intracranial hematomas after head injury (male 59 cases, female 18 cases, aged from 17-60) in the Neurosurgery Department of Cho Ray Hospital from October 2001 to August 2002. The mainly reason of admission was traffic accident. Methods of surgery were wide decompressive craniotomy and removal of hematoma without bone flap. The results: good outcomes: 62 cases, moderate outcomes: 9 cases, death: 6 cases, reoperation: 3 cases. The development of intracerebral hematomas after head injury is very complex. It can occur immediately after injury or delay although initial CT scan is normal or shows slight contusion. Therefore, the doctors must examine closely head injuries to find out delayed intracerebral hematomas for prompt operation to lessen later sequellas and mortality
diagnosis ; Hematoma ; Craniocerebral Trauma

329 subjects (234 males, 94 females) with cerebro cranial trauma were treated at Dien Bien Phu Hospital in Lai Chau province from January 1st 1994 to December 31st 1998. Results: 8/329 cases were refered to other hospital because of various other causes. 283 cases (88.16%) among them underwent internal management. 38 cases (11.84%) surgeried. Mean duration of treatment was 7.4 days. Mean post operative care 12.2 days. 293/312 cases were recovered generally (91%). Post operative recoverd cases accounted for 25/38 cases (65%) among them 22 cases were completely recovered (88%). No negligible trauma was detected at autopsy. In the conditions of basic level health facilities, X ray craniography was necessary, needing an early management.
Craniocerebral Trauma ; Therapeutics ; Diagnosis

Cervical spine injury occurs in 3% of blunt trauma patients, and 10% of patients with cervical spine injuries have an associated head injury. The early recognition of cervical spine injury and treatment of the secondary injury are important in the management of trauma patients. At the time of diagnosis of cervical spine injury, 5~30% of patients have been reported to have experienced missed or delayed diagnosis. Of these, 10.5~29% were associated with permanent and critical neurologic injury, for example, death, quadriplesia, ect. The writers experienced two cases of missed traumatic cervical spine injury.
Craniocerebral Trauma ; Delayed Diagnosis ; Diagnosis ; Humans ; Spine*

Recent advances in diagnosis and therapy for head injury have brought some changes in concepts, definition of the terms, therapeutic methods and the duration of treatment. In medical certificates, the diagnosis and duration of treatment also need to be changed according to the new concepts. Mixed use of the terms according to the classic and the new concepts may cause confusion. We investigated with a questionnaire to assess the acceptability of the new concepts of head injury, and seeked for a plan to avoid possible confusion in medical certificates. We sent questionnaires for diagnosis and duration of treatment of 10 given examples of head injury to 367 neurosurgeons whose addresses could be identified. Questionnaires were answered by 52 neurosurgeons. The diagnosis described in the questionnaires showed wide variability with a range of 10 to 32 different descriptions, on average 16.8 different descriptions for each case. Duration of treatment also revealed great discrepancy. Coefficients of variation for duration of treatment varied from 33.44% to 54.37%. Cerebral contusion was the most commonly used term. It was described in every 10 given examples, and to take an average, 32.3 neurosurgeons used cerebral contusion or each case. To avoid possible confusion in medical certificates, it is necessary to make a guide for medical certificates for head injuries according to the new concepts, and a chance of training of this guide should be provided.
Contusions ; Craniocerebral Trauma* ; Diagnosis* ; Head* ; Surveys and Questionnaires*

Clinical retrospectative study of 328 cranial trauma patients treat at Hai Phong Viet Tiep Hospital from 1/1 to 31/12/2002, all patients put on computerized tomography, male/female rate was 4/1, there were many patients aged from 20 to 50, 78% patients suffer traffic accident. Indirect injury image in C.T was 45% and direct injury image was 46%. 25% patients weve intervene surgery. 5% patients were mortality
Tomography, X-Ray Computed ; Craniocerebral Trauma ; Diagnosis

OBJECTIVE: The goal of this study is to assess the prognostic factors of patients with chronic subdural hematoma. METHODS: A series of 150 patients with chronic subdural hematoma was reviewed. The hematoma was surgically removed in all patients. We analysed possible prognostic factors such as, age, sex, causes, preoperative radiologic findings, and preoperative neurological condition(Bender grade). RESULTS: The most important prognostic factor of chronic subdural hematoma was preoperative neurological condition. Patient's age and sex, causes and preoperative radiologic findings(hematoma thickness) do not have significant influences on the outcome. CONCLUSION: The neurological condition of the patients at the time of diagnosis and treatment are the only significant prognostic factor. Early diagnosis of chronic subdural hematoma before neurological deterioration is important.
Craniocerebral Trauma ; Diagnosis ; Early Diagnosis ; Hematoma ; Hematoma, Subdural, Chronic* ; Humans

Although the life expectancy of posttraumatic persistent vegetative state is obviously expected to be shorter than that of the general population, exact estimates of the length of survival are not available, however. The author, after reviewing literatures on the definition, criteria for diagnosis, and prognosis of the persistent vegetative state, has proposed a table for the estimation of life expectancy of posttraumatic persistent vegetative state. In this proposal, age and sex of the patient as well as the duration of the vegetative state were used as determining factors of lifespan. Although this proposal is not based on the actual data, it still could serve as a helpful reference to estimate the patients life expectancy and minimizing discrepancies among clinicians with different personal experience.
Craniocerebral Trauma ; Diagnosis ; Humans ; Life Expectancy* ; Persistent Vegetative State* ; Prognosis

OBJECTIVE: This study is performed in order to compare T2* weighted magnetic resonance(T2*W MR) image to computerized tomography(CT) and conventional magnetic resonance(MR) image for the detection of minute traumatic intracerebral hemorrhage. METHODS: A series of 40 patients with head trauma underwent CT and MR image including T2*W MR sequnence. The authors compared T2*W MR image to CT and conventional MR image in the diagnosis of traumatic intracerebral hemorrhage. RESULTS: Thirty five of 40 patients(88%) were revealed the hemorrhagic foci in the T2*W MR image, whereas 30 patients(75%) were revealed in the conventional MR image, 18 patients(45%) in the CT. Therefore it is concluded that T2*W MR image is more sensitive than CT or conventional MR image in the diagnosis of minute traumatic intracerebral hemorrhage in patients with head trauma. CONCLUSION: If headache is persisted in the head trauma patients with negative CT and MR image finding, We recommend T2*W MR image.
Cerebral Hemorrhage, Traumatic* ; Craniocerebral Trauma ; Diagnosis* ; Headache ; Hemorrhage ; Humans

Before the 1970s there was no way to quantify the severity of head injury in groups of patients, but over the last two decades, medical care of the head-injured patient has evolved to a level at which clinical management decisions are based on actual measurement of relevant physiological variables and application of sound scientific principles. One of the most important reasons of such a progress is developments in medical technology. The technology has developed in a manner that now allows improved imaging of the brain as well as accurate measurement of variables such as intracranial pressure, cerebral blood flow, and brain electrical activity, all of which combine to greatly enhance the clinician's ability to monitor the injured brain. The author can not provide all the informations of advances that have taken place, or a comprehensive description of state-of-the-art technology hear, because of limited spaces. It is only hoped that this paper would afford a useful reference for those seeking newer concepts in diagnosis of head injury.
Brain ; Craniocerebral Trauma* ; Diagnosis* ; Head* ; Hope ; Humans ; Intracranial Pressure ; Neurophysiology

Background: Cranial trauma is a major cause of death among types of trauma. So far, although pediatric cranial trauma can leave more severe consequences, it has not still been adequate attended.\r\n', u'Objectives: To study clinical characteristics and cranial trauma treatment of under 16 years old children in Binh Dinh General Hospital. Subjects and method: A retrospective study was conducted on 256 under 16 year old patients with cranial trauma (180 males, 76 female) in Binh Dinh General Hospital from January, 2005 to September, 2005. Results:Cranial trauma in children was common seen in male/female ratio as 70.31/29.69. Common aged between 3-16 years old (89%). Main cause of it was traffic accident (64.5%). 100% of patients admitted to hospital with a Glasgow score 11 points. In those aged 3-16 years old, 14.03% of them with score of Glasgow coma scale \ufffd?2 points. Cranial CT scans: 78 patients, Cranial X-rays: 122 patients. Surgical rate 10.6%. Mean surgical days was 5.12\xb13.80 days. Complication rate was 33.2%. Non-operative mortality was 1.56%. Conclusion: Cranial trauma was common seen in those aged 3-16 years old, in male more than female. According to Glasgow outcome scale, good recovery rate achieved 65.23%. \r\n', u'
Craniocerebral Trauma/ diagnosis ; surgery ; therapy ; Child ; Child ; Preschool ;