[Clinical course of acute intracerebral hematoma which shows a fluid level presentation by X-ray CT]

Three cases of intracranial hematomas which showed a fluid level presentation and/or mixed density in the acute stage by X-ray CT were reported. Case 1 is a 7-year-old boy who had the epidural and intracerebral hematomas three hours after the traffic accident. During the course, intracerebral hematomas which showed a fluid-level presentation had grown both 6 and 17 hours after the episode. Case 2 is a 39-year-old female who had received an aortic valve replacement 20 years ago. She was diagnosed as cerebral infarction due to the occlusion of the right middle cerebral artery. Intracerebral hematomas with a fluid level presentation developed in the infarcted area 20 days after the embolectomy. Case 3 is a 67-year-old female who had a mild subarachnoid hemorrhage by the traffic accident. Intracerebral hematoma with mixed density developed 68 hours after the episode and it enlarged again 89 hours after the accident. All three cases showed the abnormalities in the coagulofibrinolytic activities during the hemorrhage and showed a growth of the hematomas. It should be noticed that the case which shows a mixed density and/or a fluid level presentation in the X-ray CT requires more intensive care in both neurosurgical and general management.