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[Traumatic intracerebral hemorrhage developing in the apparent course].

S Fujiwara1, A Nishimura, Y Yanagida

  • 1Department of Legal Medicine, Kobe University School of Medicine, Japan.

Nihon Hoigaku Zasshi = the Japanese Journal of Legal Medicine
|June 1, 1991
PubMed
Summary

A severe head injury led to delayed intracranial hemorrhages, including intracerebral and intracerebellar bleeding, exacerbated by high blood pressure. Autopsy confirmed extensive brain damage and contributed factors.

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Area of Science:

  • Neurology
  • Trauma Surgery
  • Forensic Pathology

Background:

  • Head trauma can result in delayed intracranial hemorrhages.
  • High blood pressure is a significant risk factor for cerebrovascular events.

Observation:

  • A 52-year-old male sustained a head injury with initial CT showing only a right subdural hematoma.
  • Delayed development of extensive intracerebral and intracerebellar hemorrhages occurred over 10.5-16 hours post-trauma.
  • Elevated blood pressure persisted throughout hospitalization, fluctuating significantly.

Findings:

  • Autopsy revealed fractures, cortical contusions, and multiple intracerebral and intracerebellar hemorrhages.
  • Computed tomography (CT) scans initially missed smaller hemorrhages that progressed.

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  • Cardiac hypertrophy and aortic atherosclerosis were noted as comorbidities.

    • Implications:

    • Subtle traumatic brain injuries can lead to severe, delayed hemorrhages, particularly in hypertensive patients.
    • Close monitoring of blood pressure and serial neuroimaging are crucial in managing head trauma.
    • High blood pressure may accelerate the development and expansion of traumatic intracranial hemorrhages.