The genesis and significance of delayed traumatic intracerebral hematoma.

Abstract:

:During a 34-month period, 12 cases of delayed traumatic intracerebral hematoma (DTICH) were diagnosed among 162 consecutive prospectively studied patients admitted to the Medical College of Virginia with severe closed head injuries. All patients were unresponsive to command and unable to utter formed words at the time of admission. The interval from injury to diagnosis of DTICH by computerized tomography (CT) was within 48 hours in 11 of the 12 cases. Six patients had no decompressive surgery before the development of the lesion. Four patients had undergone decompressive surgery and then developed DTICH on the contralateral side. Two patients developed lesions in the vicinity of the operative site that were thought not to be the result of operation. The development of DTICH was not heralded by neurological deterioration nor by elevation of intracranial pressure. Eleven of the 12 patients had suffered a secondary hypoxic insult soon after the head injury. We suggest that the CT appearance of DTICH is likely to represent hemorrhage into an existing traumatized area and is an epiphenomenon rather than a cause of severe primary and secondary brain damage.

journal_name

Neurosurgery

journal_title

Neurosurgery

authors

Gudeman SK,Kishore PR,Miller JD,Girevendulis AK,Lipper MH,Becker DP

subject

Has Abstract

pub_date

1979-09-01 00:00:00

pages

309-13

issue

3

eissn

0148-396X

issn

1524-4040

journal_volume

5

pub_type

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