Research ArticleOriginal Article
Open Access

Surgical treatment of traumatic multiple intracranial hematomas

Chaohua Yang, Qiang Li, Cong Wu, Xin Zan and Chao You
Neurosciences Journal October 2014, 19 (4) 306-311;

Article Figures & Data

Figures

  • Figure 1
    Figure 1

    A 48-year-old male with bilateral frontal lobe contusions and hematomas that were removed through a coronal incision. Non-contrast axial head computed tomography scans showing: A) pre-operative scan after injury; B) post-operation; C) follow-up with good recovery.

  • Figure 2
    Figure 2

    A 52-year-old male with bilateral pupil dilation underwent 2-site surgery. Non-contrast axial head CT scan shows: A) left fronto-temporal-parietal subdural hematoma and right temporal epidural hematoma; B) bilateral approach performed consecutively to remove the lesions with decompressive craniectomy performed on the left; C) follow-up, Glasgow Outcome Scale was 3.

  • Figure 3
    Figure 3

    A 47-year-old female underwent single-site surgery, with the remaining hematoma treated non-surgically. Non-contrast axial head CT scans showing: A) pre-operative left fronto-temporal subdural hematoma and right frontal epidural hematoma; B) post-operative scan; C) follow-up, good recovery.

Tables

  • Table 1

    Demographic details of traumatic multiple intracranial hematoma patients.

    Variablen(%)
    Patients118
    Gender (M/F)104/14(88.1/11.9)
    Cause of injury
     Traffic accident89(75.4)
     Falling2722.9)
     Hitting2(1.7)
    Severity of injury
     GCS 13-156(5.1)
     GCS 9-1210(8.5)
     GCS 3-8102(86.4)
    Brain herniation39(33.1)
     Unilateral pupil enlargement31(26.3)
     Bilateral pupil enlargement8(6.8)
    Basal cistern
     Obliteration106(89.8)
     None obliteration12(10.2)
    Midline shift
     <5 mm84(71.2)
     >5 mm34(28.8)
    Outcomes
     GOS 133(28.0)
     GOS 241(34.7)
     GOS 33(2.5)
     GOS 44(3.4)
     GOS 537(31.4)
    • Table 2

      Traumatic multiple intracranial hematoma patient classification based on injury type and sites.

      Classificationn(%)
      Different types of hematomas at the same site12(10.2)
       Intracerebral hematoma + subdural hematoma10(8.5)
       Intracerebral hematoma + epidural hematoma2(1.7)
      One hematoma type in different compartments69(58.5)
       Intracerebral hematoma61(51.7)
       Epidural hematoma6(5.1)
       Subdural hematoma2(1.7)
      Different types of hematomas in different compartments37(31.3)
       Intracerebral hematoma + epidural hematoma20(16.9)
       Intracerebral hematoma + subdural hematoma15(12.7)
       Epidural hematoma + subdural hematoma2(1.7)
    • Table 3

      Status of basal cisterns and surgical treatment among traumatic multiple intracranial hematoma patients.

      Basal cistern statusOperationNon-surgical
      Obliteration1033
      Not obliterated57
      • Table 4

        Surgical sites and outcomes among traumatic multiple intracranial hematoma patients.

        VariableFavorable outcomeUnfavorable outcome
        Single-site surgery3158
        Two-site surgery109
        • Table 5

          Outcomes between pediatric and adult groups among traumatic multiple intracranial hematoma patients.

          VariableFavorable outcomeUnfavorable outcome
          Pediatric group (age under 18)81
          Adult group (age over 18)3376
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