OBJECTIVETo explore the therapeutic methods, surgical indications and clinical practice of minimally invasive surgery on traumatic epidural hematoma (EDH).

METHODSRetrospective study was made on 135 patients with traumatic EDH admitted into our hospital from June 2002 to August 2005. Sixty-five patients were treated with mini-invasive negative pressure drainage (treatment group), 70 patients with comparable condition used traditional craniotomy (control group). The mean time of operation, average days in hospital, expenditure and prognosis of two groups were recorded and analyzed.

RESULTSThere was no significant difference in therapeutic efficacy between two groups. Patients in treatment group had a shorter hospital stay and less expenditure than those in control group.

CONCLUSIONMini-invasive negative pressure drainage is simple, effective, economical and applicable to some traumatic EDH patients.

Brain Injuries ; complications ; Female ; Hematoma, Epidural, Cranial ; surgery ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Retrospective Studies

OBJECTIVETo investigate the risk factors of progressive brain contusion and to evaluate their impact on patients' outcome.

METHODSOne hundred and thirty two patients with traumatic brain contusion were enrolled in the study, including 70 cases with progressive contusion and 62 cases with non-progressive contusion. The risk factors were investigated with univariate and multivariate Logistic regression analysis.

RESULTSThe univariate analysis showed that Glasgow Coma Score (GCS) at admission, contusion volume at the first brain CT scans, midline shift, combined with skull fracture, subarachnoid hemorrhage, epidural hematoma, subdural hematoma, location of brain contusion, D-dimer levels, combined with type 2 diabetes were associated with progressive brain contusion. Multivariate Logistic regression analysis showed that GCS at admission, contusion volume at the first CT scans, combined with subarachnoid hemorrhage, combined with type 2 diabetes were the independent risk factors for disease progression. The outcome in the progressive group was more aggravated than that in non-progressive group (P = 0.001).

CONCLUSIONPatients with disturbance of consciousness, the larger contusion volume, combined with subarachnoid hemorrhage and diabetes are at risk for progressive brain contusion and unfavorable outcome.

Brain Injuries ; complications ; pathology ; Diabetes Mellitus, Type 2 ; complications ; Disease Progression ; Fibrin Fibrinogen Degradation Products ; metabolism ; Glasgow Coma Scale ; Hematoma, Epidural, Cranial ; complications ; Hematoma, Subdural ; complications ; Humans ; Risk Factors ; Subarachnoid Hemorrhage ; complications ; Tomography, X-Ray Computed

Subarachnoid hemorrhage (SAH) can be classified as traumatic SAH or spontaneous SAH based on etiology. The traumatic SAH is the common manifestation of head injury and difficult to make a diagnosis in forensic investigation. Based on practical experiences of forensic investigation and relevant references, the main points (SAH identification, examination, death mechanism) were summarized in this article. For the understanding, we try to classify the traumatic SAH into three subtypes: brain injury associated SAH, traumatic rupture of basal cerebral vessels SAH and traumatic focal SAH.
Aneurysm, Ruptured/complications* ; Cause of Death ; Craniocerebral Trauma/complications* ; Diagnosis, Differential ; Forensic Pathology ; Hematoma, Epidural, Cranial/complications* ; Humans ; Intracranial Aneurysm/complications* ; Intracranial Arteriovenous Malformations/complications* ; Rupture/complications* ; Subarachnoid Hemorrhage/pathology* ; Subarachnoid Hemorrhage, Traumatic/pathology*

Acute Disease ; Adolescent ; Adult ; Aged ; Craniocerebral Trauma ; complications ; therapy ; Drainage ; Female ; First Aid ; methods ; Hematoma, Epidural, Cranial ; complications ; therapy ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed ; Treatment Outcome ; Trephining