Intraparenchymal and intraventricular hemorrhage without mass effect in traumatic coma.
A group of 57-head injured patients showing computerized tomographic (CT) findings compatible with "diffuse brain injury" or of the so called "diffuse axonal injury" is analyzed. Thirty-four patients showed intraparenchymal hemorrhage in the CT scan study, 8 intraventricular hemorrhage and 15 patients had both intraparenchymal and intraventricular hemorrhage. Forty percent (23/57) of those with these findings had associated intracranial focal lesions. The deep nuclei are the most common location of intraparenchymal hemorrhage. Signs of brain stem hemorrhage were seen in 9 patients. Forty-nine percent of patients in this series had a good outcome. Old age (greater than 60), abnormal motor response, abnormal eye signs, associated with focal lesions, and evidence of brain stem hemorrhage are reliable prognostic parameters for a grave outcome.
Lee
J P
JP
Department of Surgery, Chang Gung Medical College, Taipei, Taiwan, R.O.C.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D001921:Brain / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D002552:Cerebral Ventricles; D002648:Child; D002675:Child, Preschool; D003128:Coma / Q000209:etiology*; D006259:Craniocerebral Trauma / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D009068:Movement; D011379:Prognosis; D011859:Radiography; D012025:Reflex, Pupillary / Q000502:physiology