A Clinical Analysis of Delayed Traumatic Intracerebral Hematoma

ABSTRACT

The development of sophisticated diagnostic modalities, most notably computerized tomography(CT), led to an increasing awareness of delayed traumatic intracerebral hematoma(DTICH). But the general prognosis for functional recovery was poor in patients who developed DTICH. The author analysed 95 cases of DTICH admitted to the department of Neurosurgery, Dong-Guk University Hospital during three years from January 1990 to December 1992. The result were as follows 1) The incidence of the DTICH was 5.1% of all head injured patients. 2) The average age of patient was 43.3 years and the most common cause was traffic accident(61.6%). 3) Of the 95 patients who were diagnosed as DTICH, the clues to undergo follow up CT were divided as routine follow up in 39, changes of the consciousness level in 38, changes of the pupil size in 18 patients. 4) Most of the DTICH formation were related to contusion site of the brain and were more commonly associated with rotational forces. 5) Twenty-one cases of DTICH occurred within 24 hours after trauma and 18 cases at 2 days after trauma. 6) The most common site of hematoma was frontal lobe followed by temporal lobe. 7) The factors affecting prognosis (1) age(p<0.01) (2) Glasgow Coma scale(GCS) at admission(p<0.01) (3) time interval between trauma and discovery(p<0.01) (4) hematoma volume(p<0.01). Location of hematoma did not affect outcome, but the patients with multiple hematoma or basal ganglia hematoma showed higher fatality than the others. 8) The overall fatality rate was 40%.