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Related Experiment Video

Updated: Mar 28, 2026

A Preclinical Controlled Cortical Impact Model for Traumatic Hemorrhage Contusion and Neuroinflammation
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Temporal delays in trauma craniotomies.

Judith Marcoux1,2, David Bracco3, Rajeet S Saluja1,2

  • 1Department of Neurology and Neurosurgery, McGill University; and

Journal of Neurosurgery
|January 2, 2016
PubMed
Summary

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Delays in intrahospital care for traumatic intracranial mass lesions persist, impacting surgical evacuation timing. Identifying and addressing bottlenecks in imaging and operating room preparation is crucial for improving patient outcomes.

Area of Science:

  • Neurosurgery
  • Trauma Care
  • Emergency Medicine

Background:

  • Timely surgical evacuation of epidural and subdural hematomas is recommended for better patient outcomes.
  • Previous studies have not detailed intrahospital delays for traumatic intracranial mass lesions.

Purpose of the Study:

  • To characterize delays in emergency trauma craniotomies at a Level 1 trauma center.
  • To identify specific points of delay in patient care pathways.
  • To propose strategies for improving surgical care delivery.

Main Methods:

  • Retrospective review of 166 emergency trauma craniotomies over 5 years.
  • Calculation of time intervals: ED arrival to CT, CT to OR, ED to OR, OR arrival to skin incision, ED to skin incision.
  • Categorization of patients into immediate (E0) and life-threatening (E1) emergencies.
Keywords:
ED = emergency departmentEDH = epidural hematomaGCS = Glasgow Coma ScaleGOS = Glasgow Outcome ScaleISS = Injury Severity ScoreOR = operating roomSDH = subdural hematomaTBI = traumatic brain injuryacute epidural hematomaacute subdural hematomadelay in treatmentquality of caresurgerytrauma craniotomytraumatic brain injury

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Main Results:

  • Median ED-to-CT delay was 54 minutes; CT-to-OR delay was 57 minutes.
  • Median ED-to-OR arrival delay was 85 minutes for E0 and 127 minutes for E1 (p < 0.0001).
  • Median total delay from ED arrival to skin incision was 150 minutes.

Conclusions:

  • Significant delays persist in surgical evacuation for traumatic intracranial mass lesions.
  • Bottlenecks identified in imaging, operating room transfer, and preparation.
  • Strategies to reduce delays are needed to optimize patient care and outcomes.