Delayed Traumatic Intracerebral Hematoma.

An, C; Choi, B O; Kim, S C; Shim, J H

Original Article

Journal of Korean Neurosurgical Society 1991;20(8): 632-638.

Departments of Neurosurgery, Busan Paik Hospital, Inje Medical school, Busan, Korea.

ABSTRACT

Bollinger cited the following criteria for diagnosis of delayed traumatic intracerebral hematoma(DTICH) : (1) abscence of pre-existing vascular disease ; (2) a definite history of trauma ; and (3) an asymptomatic interval and a subsequent apopleciform episode. Deranged cerebrovascular autoregulation permitting increased flow to a damaged vascular bed, as well as post-traumatic coagulopathies, are proposed explanation for these lesion. 34 cases of delayed traumatic intracerebral hematoma were found retrospectively among 2,195 patients with head injury admitted to the Busan Paik hospital, Inje university in a 6-years peiod. The interval from cranial injury to diagnosis of DTICHYB computerized tomography scan varied from 4 hours to 7 days. Of these, 8 cases were conservative therapy and 26 cases were performed operation for removal of hematoma. 12 cases (35%) were obtained favorable outcome, 16 cases (47%) unfavorable outcome and 6 cases (18%) death. The development of DTICH is highly unpredictable and the possibility of this complication after head injury should be kept in mind.

Key Words: Delayed traumatic intracerbral hematoma; Head injury; CT scan; Damaged vascular bed; Post-traumatic coagulopathies