PMID: 7086910Jun 1, 1982Paper

Delayed post-traumatic extracerebral hematomas

The Journal of Trauma
J M Piepmeier, F C Wagner


Acute craniocerebral trauma remains a difficult management problems. Optimal conditions for recovery require stabilization of vital signs, removal of a mass lesion when present, and control of intracranial pressure. While computerized tomography (CT) has helped achieve these objectives, there remain patients who may develop a second extracerebral hematoma not evident on their initial preoperative scan. This report concerns our experience with patients who developed such delayed post-traumatic extracerebral hematomas shortly after evacuation of hematomas at other sites. Between 1 January 1979 and 1 October 1980, 47 patients underwent emergency evacuation of a traumatic extracerebral hematoma (38 acute subdural and 18 acute epidural hematomas) at the Yale New Haven Hospital. Within 24 hours, four patients developed, in addition, a total of six delayed extracerebral hematomas (10%) which also required evacuation. In all of these patients a skull fracture was present at the site of the delayed hematomas. This experience suggests: 1) Exploration of extracerebral space beneath a skull fracture should be considered following evacuation of a hematoma at another site. 2) Repeat CT is indicated if anticipated improvement does not occur a...Continue Reading


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Related Concepts

Mild Traumatic Brain Injury
Hematoma, Epidural, Cranial
Subdural Hematoma, Traumatic
Intracranial Pressure
Linear Skull Fracture
Tomography, X-Ray Computerized Axial

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Brain Injury & Trauma

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