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[Surgical indications in space-occupying contusion hemorrhage]
R Schneider1, U M Mauer, H Waldbaur
1Neurochirurgische Abteilung, Bundeswehrkrankenhauses Ulm, Universität Ulm.
Der Unfallchirurg
|November 1, 1993
Summary
Severe head injuries often involve traumatic intracerebral hematomas. Surgical removal remains controversial, with most patients presenting with additional injuries, impacting mortality rates.
Area of Science:
- Neurosurgery
- Trauma Surgery
- Neuroradiology
Background:
- Traumatic intracerebral hematomas are a frequent neurosurgical emergency.
- The efficacy of surgical intervention for these hematomas is debated.
- Urgent management of thoracic or abdominal hemorrhage often takes precedence over neurosurgical interventions.
Purpose of the Study:
- To analyze the characteristics and outcomes of patients with severe head injuries and contusion-induced hematomas.
- To investigate the incidence of isolated versus associated injuries in patients with traumatic intracerebral hematomas.
- To evaluate the management strategies and mortality associated with these injuries.
Main Methods:
- Retrospective analysis of 318 patients with severe head injury.
- Computed tomography (CT) scans were used for diagnosis.
- Data collected included patient demographics, injury types, surgical interventions, and mortality.
Main Results:
- Out of 318 patients, 161 had contusion-induced hematomas (38 female, 123 male).
- The overall mortality rate was 18.6%.
- Contusion hematomas were often associated with other injuries, including epidural hematomas, subdural hematomas, depressed skull fractures, and subarachnoid hemorrhage. Isolated contusion hematomas were rare (10.6%).
Conclusions:
- Contusion-induced hematomas in severe head injuries are frequently accompanied by other traumatic lesions.
- The high rate of associated injuries complicates management and influences outcomes.
- Surgical intervention for contusion hematomas was performed in a small subset of patients.