Hemorragia subaracnoidea aneurismática en la unidad de cuidados intensivos del Hospital Luis Vernaza, Guayaquil, Ecuador / Aneurysmal subarachnoid hemorrhage in the intensive care unit of Luis Vernaza Hospital, Guayaquil, Ecuador

La hemorragia subaracnoidea puede producirse por un traumatismo cráneo encefálico o cuando el denominado aneurisma (defecto en la estructura de la pared de un vaso sanguíneo) se rompe produciendo flujo de sangre en el espacio subaracnoideo. Al respecto, se desarrolló un estudio con enfoque mixto, de tipo no experimental, descriptivo, longitudinal prospectivo; cuyo fin fue describir la hemorragia subaracnoidea aneurismática en pacientes atendidos en la unidad de cuidados intensivos del Hospital Luis Vernaza, en la ciudad de Santiago de Guayaquil, Ecuador, durante el período comprendido desde enero hasta septiembre de 2016. En el mismo participa-ron 31 pacientes con diagnóstico de hemorragia subaracnoidea aneurismática, los que fueron atendidos en ese servicio de la institución en cuestión. Entre los resultados observados se puede destacar que: 24 de los 31 involucrados eran de género femenino, más del 90% de la población de estudio tenían más de 40 años de edad; la arteria comunicante posterior resultó la más afecta-da en los pacientes estudiados (32,26 %); el 58,33% de los casos tuvo compromiso cerebral con distintos grados de afectación; el 38,71% de la población de estudio desarrolló isquemia cere-bral tardía; se estableció una relación estadísticamente significativa entre esa última complica-ción y la administración de ácido tranexámico como parte del tratamiento para evitar resangra-do, el que se presentó solamente en el 16,13% de los pacientes participantes.

Subarachnoid hemorrhage can be caused by a traumatic brain injury or when the so-called aneu-rysm (defect in the structure of the wall of a blood vessel) ruptures causing blood flow in the subarachnoid space. Based on this, it was developed a study with a mixed approach, of a non-ex-perimental, descriptive, longitudinal, prospective type in order to describe aneurysmal subara-chnoid hemorrhage in patients treated in the intensive care unit of Luis Vernaza Hospital, in the city of Santiago de Guayaquil, Ecuador, during the period from January to September 2016. The study population was constituted by 31 patients diagnosed with aneurysmal subarachnoid hemo-rrhage and treated at the service mentioned above. The results were: 24 of the 31 patients were female, more than 90% of the study population were over 40 years of age. The posterior commu-nicating artery was the most affected in the patients representing 32.26%, 58.33% of the cases had cerebral involvement with different degrees of involvement, 38.71% of the patients develo-ped late cerebral ischemia. A statistically significant relationship was established between this last complication and the administration of tranexamic acid as part of the treatment to avoid rebleeding, which occurred only in 16.13% of the participating patients.

Evacuación de hematoma subdural crónico: hemorragia de Duret postoperatoria y restitución ad-integrum. A propósito de un caso / Evacuation of chronic subdural hematoma: postoperative Duret hemorrhage and ad-integrum replacement. About a case

El tratamiento de elección para la evacuación de hematoma subdural crónico es la evacuación mediante orificio de trépano. Las complicaciones más frecuentes son recurrencia, neumoencefalo, convulsiones, hemorragia intracraneal y en otros sitios. La hemorragia del tronco cerebral secundaria a la cirugía es extremadamente rara. Aquí presentamos un paciente masculino de 72 años, que ingresa con GSC 9/15, hemiparesia izquierda 2/5. Con HSD crónico bilateral con desplazamiento de línea media de 1.5 cm. hacia izq. Al cual se realiza evacuación de HSD derecho. Y en el POP se detecta GSC 12/15, lado izquierdo fuerza 5/5, con hemiparesia derecha a predominio braquial. TC control POP: adecuada evacuación de HSD y lesión hiperdensa protuberancial. Es externado al 6to día POP con GSC 14/15 sin déficit motor. Este reporte, además de abordar la bibliografía actual y fisiopatología; agrega otro caso para reafirmar la posibilidad de pronóstico favorable en ésta patología

ABSTRACT The treatment of choice for the evacuation of chronic subdural hematoma is evacuation through a trepan orifice. The most frequent complications are recurrence, re-accumulation of the hematoma, pneumoencephalus, seizures, intracranial hemorrhage and elsewhere. Brainstem hemorrhage secondary to surgery is extremely rare. Here we present a 72-year-old male patient, admitted with GSC 9/15, left hemiparesis 2/5. Without obeying orders. With bilateral chronic HSD with midline displacement of 1.5 cm. to left; to which evacuation of right HSD is performed. And in the POP GSC 12/15 is detected, left side force 5/5, with right hemiparesis to brachial predominance. POP control CT: adequate evacuation of HSD and hyperdense pontine lesion. It is extership to the 6th day POP with GSC 14/15 without motor deficit. This report, besides addressing the current bibliography and physiopathology; adds another case to reaffirm the possibility of favorable prognosis in this pathology

Predictable Values of Decompressive Craniectomy in Patients with Acute Subdural Hematoma: Comparison between Decompressive Craniectomy after Craniotomy Group and Craniotomy Only Group / 대한신경손상학회지

OBJECTIVE: Patients with traumatic acute subdural hematoma (ASDH) often require surgical treatment. Among patients who primarily underwent craniotomy for the removal of hematoma, some consequently developed aggressive intracranial hypertension and brain edema, and required secondary decompressive craniectomy (DC). To avoid reoperation, we investigated factors which predict the requirement of DC by comparing groups of ASDH patients who did and did not require DC after craniotomy. METHODS: The 129 patients with ASDH who underwent craniotomy from September 2007 to September 2017 were reviewed. Among these patients, 19 patients who needed additional DC (group A) and 105 patients who underwent primary craniotomy only without reoperation (group B) were evaluated. A total of 17 preoperative and intraoperative factors were analyzed and compared statistically. Univariate and multivariate analyses were used to compare these factors. RESULTS: Five factors showed significant differences between the two groups. They were the length of midline shifting to maximal subdural hematoma thickness ratio (magnetization transfer [MT] ratio) greater than 1 (p 1, IVH, and TICH on preoperative brain computed tomography images, intraoperative signs of intracranial hypertension, brain edema, and bleeding tendency were identified as factors indicating that DC would be required. The necessity for preemptive DC must be carefully considered in patients with such risk factors.

The effect of tranexamic acid in traumatic brain injury: A randomized controlled trial / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>Traumatic brain injury (TBI) is a leading cause of death and disability. Intracranial hemorrhage (ICH) secondary to TBI is associated with a high risk of coagulopathy which leads to increasing risk of hemorrhage growth and higher mortality rate. Therefore, antifibrinolytic agents such as tranexamic acid (TA) might reduce traumatic ICH. The aim of the present study was to investigate the extent of ICH growth after TA administration in TBI patients.</p><p><b>METHODS</b>This single-blind randomized controlled trial was conducted on patients with traumatic ICH (with less than 30 ml) referring to the emergency department of Vali-Asr Hospital, Arak, Iran in 2014. Patients, based on the inclusion and exclusion criteria, were divided into intervention and control groups (40 patients each). All patients received a conservative treatment for ICH, as well as either intravenous TA or placebo. The extent of ICH growth as the primary outcome was measured by brain CT scan after 48 h.</p><p><b>RESULTS</b>Although brain CT scan showed a significant increase in hemorrhage volume in both groups after 48 h, it was significantly less in the TA group than in the control group (p = 0.04). The mean total hemorrhage expansion was (1.7 ± 9.7) ml and (4.3 ± 12.9) ml in TA and placebo groups, respectively (p < 0.001).</p><p><b>CONCLUSION</b>It has been established that TA, as an effective hospital-based treatment for acute TBI, could reduce ICH growth. Larger studies are needed to compare the effectiveness of different doses.</p>

Clinical Factors and Perioperative Strategies Associated with Outcome in Preinjury Antiplatelet and Anticoagulation Therapy for Patients with Traumatic Brain Injuries

OBJECTIVE: Long-term oral anticoagulation or antiplatelet therapy has been used with increasing frequency in the elderly. These patients are at increased risk of morbidity and mortality from expansion of intracranial hemorrhage. We conducted a single-center retrospective case control study to evaluate risk factors associated with outcomes and to identify the differences in outcome in traumatic brain injury between preinjury anticoagulation use and without anticoagulation. METHODS: A retrospective study of patients who underwent craniotomy or craniectomy for acute traumatic cerebral hemorrhage, between January 2005 and December 2014 was performed. RESULTS: A consecutive series of 50 patients were evaluated. The factors significantly differed between the two groups were initial Prothrombin Time-International Normalized Ratio, initial platelet count, initial Glasgow Coma Scale score, and postoperative intracranial bleeding. Mean Glasgow Outcome Scale (GOS) score were similar between the two groups. In the patient with low-energy trauma only, no significant differences in GOS score, postoperative bleeding and many other factors were observed. The contributing factors to postoperative bleeding was preinjury anticoagulation and its adjusted odds ratio was 12 [adjusted odds ratio (OR), 12.242; p=0.0070]. The contributing factors to low GOS scores, which mean unfavorable neurological outcomes, were age (adjusted OR, 1.073; p=0.039) and Rotterdam scale score for CT scans (adjusted OR, 3.123; p=0.0020). CONCLUSION: Preinjury anticoagulation therapy contributed significantly to the occurrence of postoperative bleeding. However, preinjury anticoagulation therapy in the patients with low-energy trauma did not contribute to the poor clinical outcomes or total hospital stay. Careful attention should be given to older patients and severity of hemorrhage on initial brain CT.

A Decade of Research on TLR2 Discovering Its Pivotal Role in Glial Activation and Neuroinflammation in Neurodegenerative Diseases

Toll-like receptors (TLRs) belong to a class of pattern recognition receptors that play an important role in host defense against pathogens. TLRs on innate immune cells recognize a wide variety of pathogen-associated molecular patterns (PAMPs) and trigger innate immune responses. Later, it was revealed that the same receptors are also utilized to detect tissue damage to trigger inflammatory responses in the context of non-infectious inflammation. In the nervous system, different members of the TLR family are expressed on glial cells including astrocytes, microglia, oligodendrocytes, and Schwann cells, implicating their putative role in innate/inflammatory responses in the nervous system. In this regard, we have investigated the function of TLRs in neuroinflammation. We discovered that a specific member of the TLR family, namely TLR2, functions as a master sentry receptor to detect neuronal cell death and tissue damage in many different neurological conditions including nerve transection injury, intracerebral hemorrhage, traumatic brain injury, and hippocampal excitotoxicity. In this review, we have summarized our research for the last decade on the role of TLR2 in neuroinflammation in the above neurological disorders. Our data suggest that TLR2 can be an efficient target to regulate unwanted inflammatory response in these neurological conditions.

Traumatic Intracerebral Hemorrhage after Reduction Malarplasty / 대한신경손상학회지

Reduction malarplasty (RMP) to reshape the facial contour is one of the most popular aesthetic surgical procedures in Asia. Here we report a case of intracerebral hematoma (ICH) after RMP. A 31-year-old woman was referred to our hospital following RMP. On arrival at our emergency room, she presented with deep drowsy mentality and right hemiparesis. Computed tomographic scan demonstrated an ICH. We conducted stereotactic aspiration of the blood clots. Because of increased ICH after the operation, the patient underwent craniotomy and hematoma evacuation. After removal of hematoma, intraoperatively a defect of the middle cranial fossa dura, a skull base bony defect, and a bony fragment were noticed. We think that these lesions have been caused by aggressive manipulation of surgical instruments. To our knowledge, ICH after RMP was not reported. The radiologic features of this case and suggested mechanism of the complication are described.

Intracerebral hemorrhage in children

Intracerebral hemorrhage [ICH] in children is relatively less common as compared to adults. It could be traumatic or spontaneous. There are limited studies about ICH in children. In this study, we analyze the etiology, clinical features, management options and outcome assessment in this population. All patients with intracerebral hemorrhage under 18 years of age admitted to the neurosurgery department; Alexandria University Main Hospital and Medical Research Institute over a period of one year [June 2008-May 2009] were subjected to clinical examination, laboratory and radiological investigations and the cause of hemorrhage was determined. Thirty patients with ICH were included in this study. Age of patients ranged from one month to 17.5 years with a higher predilection in males. Presenting features were symptoms of raised intracranial pressure [60%], deterioration in sensorium [46%], limb weakness [36%] and seizures [30.0%]. Trauma was the most common cause of ICH and was found in 13 patients [43%], followed by bleeding diathesis in nine patients [30%], arteriovenous malformation [AVM] in five patients [17%], intracranial tumor in two patients and an aneurysm in one patient. Treatment modalities consisted of: hematoma evacuation, excision of AVM, AVM emobilization, aneurysm clipping, tumor excision, and conservative management. Eleven patients were treated conservatively and 19 patients were treated surgically. The outcome showed: good recovery in 14[47%], fair recovery in seven [23%], poor recovery in seven [23%], and death in two patients [7%]. Trauma is the leading cause of ICH in children. Bleeding diathesis and AVM come next. The initial neurological status of patients, the size, location and underlying pathophysiology of the hematoma are the most important determinants of patient outcome. Intracerebral hemorrhage due to bleeding diathesis was generally associated with a better outcome

Craneotomía limitada para el tratamiento de los hematomas traumáticos agudos en el adulto mayor / Limited craniotomy as treatment of acute traumatic hematoma in the elderly

El tratamiento quirúrgico de los hematomas yuxtadurales traumáticos en el adulto mayor es un tema complejo y controversial por la elevada mortalidad que lo acompaña. Objetivo: presentar los resultados preliminares de la aplicación de la craneotomía limitada para la evacuación de los hematomas yuxtadurales traumáticos agudos en el adulto mayor. Método: estudio descriptivo de los resultados del tratamiento quirúrgico de los hematomas yuxtadurales traumáticos agudos en 19 pacientes con 60 años y más, atendidos por el Servicio de Neurocirugía del Hospital Universitario Manuel Ascunce Domenech, en el período de enero de 2008 a diciembre de 2010. Resultados: en 17 pacientes la Tomografía Axial Computarizada de cráneo mostró la presencia de hematomas subdurales agudos hemisféricos. El 58.8 % de los pacientes con hematoma subdural agudo y el 100 % con hematomas intracerebrales fallecieron. Se realizaron 18 craneotomías limitadas, logró sobrevivir el 39 % de los pacientes.

The surgical treatment of traumatic hematomas in the elderly is a complex and controversial topic due to its associated high mortality rate. Objective: the purpose of this article is to present the preliminary findings on the use of limited craniotomy for the evacuation acute juxtadural traumatic hematomas in the elderly. Method: a descriptive study on the surgical treatment results of acute juxtadural traumatic hematomas was conducted involving 19 elderly patients of 60 years and over treated in the Neurosurgical service at the University Hospital “Manuel Ascunce Domenech” from January 2008 to December 2010. Results: CAT scan results revealed the presence of acute hemispheric subdural hematomas in 17 patients. The 58,8 % of patients diagnosed with acute subdural hematoma as well as the 100 % of those with intracerebral hematomas died. Eighteen limited craniotomies were performed with a 39 % survival rate.

Application of α-lipoic acid beyond peripheral diabetic polyneuropathy (A report of 3 cases).

Background: In Germany, lipoic acid is registered with the indication of “peripheral diabetic polyneuropathy”. This report intends to demonstrate therapeutic activity beyond this indication. In Indonesia, the substance is not registered for therapy. Methods: Three patients (two of them in Germany and one in Indonesia) with pathoneurological symptoms different from peripheral diabetic polyneuropathy were treated with α-lipoic acid: i) post-borelliosis infl ammation with arthritic and paraesthetic symptoms, ii) post-operative (mamma carcinoma) and post-chemotherapeutic sensoric and motoric neural deficits occurring in parallel with additional radiation therapy, and iii) post-traumatic (cerebral) and postoperative (brain surgery) cardiovascular and pulmonary crisis with broad pathoneurological (sensoric and motoric, visual, auditory) deficits and dysarthria. Results: All three patients improved in close correlation with the onset and continuation of lipoic acid intake, whereas other therapeutic measures did not appear very successful. It cannot be ruled out that the other therapeutic regimens applied interacted with lipoic acid in a supporting additive or synergistic manner, because three cases as reported here do not allow for such conclusion; however, separately, or with interaction, lipoic acid helped the patients to recover from their pathoneurological symptoms in the meaning of the traditional medical term “restitutio ad integrum”. Conclusion: In the three cases in this study, lipoic acid was effective in therapy of pathoneurological symptoms different from peripheral diabetic neuropathy. Further confirmative studies are suggeted.

Measurement of intracranial hematoma volume by personal computer / 中南大学学报(医学版)

OBJECTIVE@#To explore the method for intracranial hematoma volume measurement by the personal computer.@*METHODS@#Forty cases of various intracranial hematomas were measured by the computer tomography with quantitative software and personal computer with Photoshop CS3 software, respectively. the data from the 2 methods were analyzed and compared.@*RESULTS@#There was no difference between the data from the computer tomography and the personal computer (P>0.05).@*CONCLUSION@#The personal computer with Photoshop CS3 software can measure the volume of various intracranial hematomas precisely, rapidly and simply. It should be recommended in the clinical medicolegal identification.

Desarrollo de glioblastoma multiforme tras una hemorragia intracerebral: reporte de un caso / Development of glioblastoma multiforme after intracerebral hemorrhage: case report

Varios factores han sido implicados como posibles causantes del desarrollo de tumores cerebrales; son pocos los autores que han proporcionado evidencia de la etiología traumática de un tumor cerebral. Presentamos el caso de un paciente masculino de 30 años quien se presento con un cuadro clínico de cefalea intensa de 15 días de evolución. Los estudios imagenológicos (TAC, RMN) revelaron lesión frontal intra axial. Se le realizo resección total de la lesión, cuyo resultado de patología fue compatible con glioblastoma multiforme. El paciente tenía antecedente de hemorragia intracerebral espontanea hacia 7 meses en el mismo lugar del tumor. Basados en la literatura en relación a glioblastoma multiforme y lesión traumática o vascular cerebral, hacemos una revisión crítica de ella.

Traffic accidents; correlation between skull fractures and intracranial lesions

To find out the correlation between different types of skull fractures and intracranial lesions in traffic accidents. Patients examined in surgical emergency Allied Hospital, Punjab Medical College, Faisalabad. Two years from 1st January 1996 to 31 December 1997. In this study, the reports belonging to surviving 250 cases that had head injuries in traffic accidents were examined retrospectively. Data was collected from surgical emergency record office. Collected information was analyzed with descriptive and inferential statistics. The rate of intracranial lesions among the cases with the skull fracture was 39.0%, while the rate of skull fracture among the cases with the intracranial lesion was 50.3% [P<0.001]. Depressed fractures were more in males, while linear fractures were more in females as well as in young males as whole intracranial lesions were less in patients with skull fracture due to lower intra cranial pressure

Neurogenic stunned myocardium following hemorrhagic cerebral contusion

Neurogenic stunned myocardium [NSM] is a well-known complication of subarachnoidal hemorrhage, but has been reported rarely in association with other central nervous system disorders. A case of NSM is described in a patient with hemorrhagic brain contusion associated with cerebral edema. An 18-year-old man was admitted with severe cranial trauma following a car roll-over. Six days after admission, he developed findings suggestive for NSM. The troponin T and creatine kinase-MB level were elevated and echocardiogram showed apical and inferoposterior hypokinesis and diffuse left ventricular akinesis with severely reduced ejection fraction [18%]. Invasive measurements confirmed low cardiac output. His cardiac function resolved completely within 6 days after decompressive craniotomy. This case supports the presumed unifying role of the increased intracranial pressure, probably triggering a vigorous sympathetic outflow hyperactivity leading to NSM

Neurogenic stunned myocardium following hemorrhagic cerebral contusion

Neurogenic stunned myocardium NSM is a well-known complication of subarachnoidal hemorrhage, but has been reported rarely in association with other central nervous system disorders. A case of NSM is described in a patient with hemorrhagic brain contusion associated with cerebral edema. An 18-year-old man was admitted with severe cranial trauma following a car roll-over. Six days after admission, he developed findings suggestive for NSM. The troponin T and creatine kinase-MB level were elevated and echocardiogram showed apical and inferoposterior hypokinesis and diffuse left ventricular akinesis with severely reduced ejection fraction 18%. Invasive measurements confirmed low cardiac output. His cardiac function resolved completely within 6 days after decompressive craniotomy. This case supports the presumed unifying role of the increased intracranial pressure, probably triggering a vigorous sympathetic outflow hyperactivity leading to NSM

Expanding traumatic intracerebral contusion/hematoma.

BACKGROUND AND AIMS: Delayed traumatic hematomas and expansion of already detected hematomas are not uncommon. Only few studies are available on risk factors of expanding hematomas. A prospective study was aimed to find out risk factors associated with such traumatic lesions. MATERIALS AND METHODS: Present study is based on 262 cases of intracerebral hematomas / contusions out of which 43 (16.4%) hematomas expanded in size. computerized tomography (CT) scan was done in all the patients at the time of admission and within 24 hours of injury. Repeat CT scan was done within 24 hours, 4 days and 7 days. Midline shift if any, prothrombin time, activated partial thromboplastin time, bleeding time, clotting time and platelet counts, Glasgow coma scale at admission and discharge and Glasgow outcome score at 6 months follow up were recorded. RESULTS: Twenty six percent, 11.3 and 0% patients developed expanding hematoma in Glasgow Coma scale (GCS) of 8 and below, 9-12 and 13-15 respectively. The chances of expanding hematomas were higher in patients with other associated hematomas (17.4%) as compared to isolated hematoma (4.8%) (Fisher's exact results P =0.216). All the cases of expanding hematoma had some degree of midline shift and considerably higher proportion had presence of coagulopathy. The results of logistic regression analysis showed GCS, midline shift and coagulopathy as significant predictors for the expanding hematoma. Thirty nine patients (90.7%) of the total expanding hematomas developed within 24 hours of injury. CONCLUSIONS: Enlargement of intracerebral hematomas is quite common and majority of them expand early after the injury. These lesions were common in patients with poor GCS, associated hematomas, associated coagulopathy and midline shift.

A influência da hiperglicemia como fator prognóstico em pacientes com hematoma intraparenquimatoso encefálico espontâneo relacionado à hipertensão arterial / The influence of hyperglycemia on neurogical outcome inpatients with promary spontaneous intracerebral hematoma related to hypertension

Examinar a relação da hiperglicemia e da pressão arterialcom o prognóstico neurológico de pacientes com hematoma intraparenquimatoso encefálico espontâneo, relacionado à hipertensão arterial. Método: estudamos, retrospectivamente, a evolução clínica de 100 pacientes com hematoma intraparenquimatosoencefálico espontâneo submetidos ao tratamento cirúrgico para drenagem do hematoma, na Santa Casa de São Paulo, no período de janeiro de 2000 a dezembro de 2004. Os pacientes foram subdivididos em dois grupos: un grupo de evolução favorável (escores 4 e 5 na Escala de Prognóstico Neurológico) e outro desfavorável (escores 1,2 e 3 na Escala de Prognóstico Neurológico). Resultados: os doentes com evolução neurológica desfavorável apresentaram níveis significativamente maiores de glicemis e de pressão arterial, tanto na admissão quanto na evolução pós-operatória. Os pacientes co prognóstico favorável foram siginificativamente mais jovens,a dmitidos com a pontuação na Escala de Coma de Glasgow significativamente maior (em média, acima de 12) e apresentaram período de internação mais prolongado. Conclusão: a hiperglicemis e a hipertensão arterial sistêmica são componentes frequentes nas lesões neurológicas, sendo indicadores significativos de gravidade e confiáveis para a avaliação do prognóstico neurológico.

Las fracturas lineales de cráneo como factor de riesgo en pacientes con traumatismo craneoencefálico menor / The linear skull fracture as a risk factor in patients with minor head trauma

Introducción: La identificación de factores de riesgo que influyen sobre el pronóstico de pacientes con traumatismo craneoencefálico menor es un primer paso hacia la disminución de la morbilidad y la mortalidad por esta causa. Dentro de ellos, las fracturas de cráneo tienen una importancia práctica considerable en relación con la aparición de hematomas intracraneales postraumáticos en estos casos. Objetivo: Determinar y cuantificar la influencia de las fracturas lineales de cráneo en la aparición de hematomas intracraneales en pacientes con traumatismo craneoencefálico menor. Pacientes y Métodos: Se realizó un estudio retrospectivo de 294 pacientes ingresados por traumatismo craneoencefálico menor desde el 1ro de mayo del 2004 hasta el 30 de abril del 2005, a los cuales se les practicó exámenes de Rx simple y tomográfico de cráneo entre las 24 y las 48 horas del trauma. Se estimó, por un análisis univariado, la influencia de las fracturas de cráneo en la aparición de hematomas intracraneales yuxtadurales después de sufrir un traumatismo de este tipo. Resultados: Los pacientes que tuvieron algún tipo de fractura lineal de bóveda craneal (14,28 por ciento), tuvieron una probabilidad 38,15 veces mayor (IC 95 por ciento 10,84-147,31) de tener un hematoma intracraneal yuxtadural en comparación con los que no presentaron esta condición (85,71 por ciento). Veinte pacientes de nuestra serie presentaron hematomas intracraneales, de ellos solo cuatro (1,36 por ciento) requirieron cirugía. Conclusiones: La presencia de fractura lineal de cráneo constituye un factor de riesgo importante para la aparición de algún tipo de hematoma yuxtadural en pacientes con traumatismo menor de cráneo.