Analysis of three methods of surgical intervention in the management of traumatic intracranial hematomas

In the present study we discuss the methods of surgical intervention that are used in the management of traumatic intracranial hematomas in different periods after the craniocerebral trauma and the likelihood of hematoma recurrence after surgery. A total of 550 cases were retrospectively analysed. These patients were operated on employing osteoplastic trephination with a trephine Dofin, osteoclastic trephination, and osteoplastic trephination of the skull using a bone flap with 4 or 5 burr holes. The study results revealed that the greatest number of recurrences developed in the acute period of the trauma after performance of osteoclastic skull trephination. Osteoplastic trephinations using a bone flap with 4 or 5 burr holes yielded the fewest recurrences. In the periods after the fourth day of the trauma, corresponding to hematomas with subacute and chronic course, there was no statistically significant differences in the results after application of any one of the three methods of surgical interventions. A modification of the osteoplastic trephination with 4 burr holes is proposed. This method gave the best results in the operated patients in the three periods after cerebrocranial trauma.