[Surgical indications in space-occupying contusion hemorrhage]

Traumatic intracerebral haematomas are a common neurosurgical emergency. The role of surgical removal is controversial. The diagnosis and treatment of life-threatening thoracic or abdominal haemorrhage is more urgent than are measures undertaken by the neurosurgeon. In the present paper we report on 318 patients with severe head injury. In 161 cases (38 female, 123 male) CT investigation showed a a resulting from contusion. About a third of each group of patients, both with and without contusion-induced haematomas, were 21-30 years old. The mortality rate was 18.6%. Multiple contusion haematomas occurred in 36%, and solitary ones in 64%. The diagnostic investigations showed contusion haematomas in isolation only in 10.6% of patients. All others had additional injuries: epidural haematomas in 24 cases, subdural haematomas in 29, depressed fractures of the skull in 6, and traumatic subarachnoid haemorrhage in 37. Only 10 patients underwent operative removal of their contusion haematomas by trepanation and 2 others by stereotactic puncture.