Clinical Analysis of Traumatic Intracerebral Hematoma.

Kim, Young Sik; Kang, Sam Suk; Lee, Jung Chung; Woo, Jung Hyun

Original Article

Journal of Korean Neurosurgical Society 1978;7(2): 363-376.

Young Sik Kim, Sam Suk Kang, Jung Chung Lee, Jung Hyun Woo

Department of Neurosurgery, Chonnam University Medical School, Gwangju, Korea.

ABSTRACT

Twenty seven cases(1.7%) of traumatic intracerebral hematoma among in-patients of head injury had been operated in the Department of Neurosurgery, Chonnam University Hospital from June, 1973 to May, 1978. We attempted to analyse these cases clinically and discussed with the review of the literature. The results were summarized as follows: In the age and sex distribution, the common incidence of age was between third and fifth decade and 25 cases were male and 2 female. 2) The most common cause of trauma was traffic accident(13 cases:48.2%) and others were pedestrian(7 cases:25.9%), fall(5 cases:18.5%) and direct blow(2 cases:7.4%). 3) 3 types of the course of consciousness from accident to admission were unconscious to lucid to unconscious(13 cases), unconscious throughout(13 cases) and lucid throughout(1 case). There were no relationship between the course of consciousness and the site of the lesion. 4) The site of impact of the original blow on the head were almost the lateral blows(23 cases), while axial ones were only 4 cases(include one unknown case). The intracerebral hematoma tended to be caused more often by contre-coup injuries(21 cases) rather than by coup one(6 cases). 5) There were 14 hematomas in the temporal lobe(51.9%), 11 in the frontal lobe(40.7%) and 2 in the fronto-temporal lobe(7.4%). Among the 27 cases, only 6 cases were simple intracerebral hematomas, 16 cases were associated with subdural hematomas and 5 cases with epidural hematomas. 6) On the neurological findings, anisocoria was noted in 22 cases(81.5%), hemiparesis in 21 cases(78.0%), aphasia in 5 cases(15.0%) and decerebrate rigidity in 7 cases(26.0%). 7) Cerebral angiography disclosed specific findings due to the location and pathogenesis of hematoma;The angiographic evidence of intracerebral hematoma in the frontal lobe was quite same with the tumor in this site. The intracerebral hematoma in the temporal lobe showed displacement of middle cerebral artery with or without shifting of anterior cerebral artery to opposite side. 8) In all of cases, the osteoplastic craniotomy had been performed and the hematoma contents were evacuated through the puncture or the cortical incision. The mortality rate was 29.6%.