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Published on: October 15, 2021
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Risk Factors and Preventive Measures for Delayed Intracranial Hematoma Following Surgery for Severe Traumatic Brain
1Neurosurgery Department, Panan County People's Hospital, 322399 Jinhua, Zhejiang, China.
Annali Italiani Di Chirurgia
|July 16, 2025
Summary
Delayed intracranial hematoma (DIH) after severe traumatic brain injury (sTBI) is linked to specific risk factors. Identifying these, such as high Rotterdam CT scores and elevated blood pressure, can guide preventive strategies.
Area of Science:
- Neurosurgery
- Trauma Surgery
- Critical Care Medicine
Background:
- Severe traumatic brain injury (sTBI) poses significant challenges, with delayed intracranial hematoma (DIH) being a serious complication.
- Decompressive craniectomy is a vital procedure for managing sTBI, but DIH can occur postoperatively.
Purpose of the Study:
- To identify independent risk factors for DIH following decompressive craniectomy in sTBI patients.
- To explore potential preventive measures for DIH in this high-risk population.
Main Methods:
- Retrospective analysis of clinical data from 132 sTBI patients undergoing decompressive craniectomy.
- Comparison of patient characteristics between a control group (no DIH) and a study group (with DIH).
- Multivariate logistic regression to determine independent risk factors for DIH.
Main Results:
- Independent risk factors for DIH include a preoperative Rotterdam CT score >3, Glasgow Coma Scale (GCS) ≤8, prolonged thrombin time (TT), and elevated systolic (SBP) and diastolic blood pressure (DBP).
- Patients who developed DIH had significantly longer TT and activated partial thromboplastin time (APTT), higher SBP and DBP, and lower fibrinogen levels compared to controls.
- Higher proportions of patients in the DIH group presented with Rotterdam CT score >3, GCS ≤8, skull fractures, and epidural hematoma.
Conclusions:
- Preoperative Rotterdam CT score >3, skull fractures, prolonged TT, and elevated SBP/DBP are key independent risk factors for DIH post-decompressive craniectomy in sTBI.
- Targeted preventive strategies and timely interventions for high-risk patients are crucial to reduce DIH incidence.
- Further multicenter studies are needed to validate findings and explore additional contributing factors.
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