[Enlarging of intracranial hemorrhagic lesions and coagulative-fibrinolytic abnormalities in multiple-injury patients].
The clinical course of ten cases of head injury complicated with multiple systemic injuries were studied by comparing two groups divided according to the presence or absence of associated coagulative-fibrinolytic abnormality. All these cases had intracranial hemorrhagic lesions proven by the high density area in the initial CT scan. Five cases showed signs of disseminated intravascular coagulation (DIC) as evidenced by decreased counts of platelet, and/or elevated value of FDP at the time of admission. Four cases out of these five were in a state of hemorrhagic shock. All these five cases showed a subsequent enlargement of intracranial hematoma. Four cases died. Two of them, who had low initial Glasgow Coma Scale (G.C.S) died of uncontrollable increase of intracranial pressure. The other two, who had high initial G.C.S., died of acute renal failure and multiple organ failure. In contrast with these cases, five cases without signs of DIC intracranial hematomas did not enlarge in spite of the similar neurological conditions to the former group. In head injured patients with systemic injury, DIC frequently causes secondary hemorrhage in the intracranial lesions of minor severity.
Department of Neurosurgery, Sapporo Medical College.
Y
Y
Kurokawa
K
K
Hashi
T
T
Uede
S
S
Matsumura
S
S
Kashiwabara
M
M
Ishiguro
D000293:Adolescent; D000328:Adult; D000368:Aged; D001777:Blood Coagulation; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000473:pathology*; D002648:Child; D006259:Craniocerebral Trauma / Q000097:blood / Q000150:complications; D004211:Disseminated Intravascular Coagulation / Q000097:blood / Q000150:complications; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005342:Fibrinolysis; D006406:Hematoma / Q000209:etiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000097:blood* / Q000150:complications; D010976:Platelet Count
D005338:Fibrin Fibrinogen Degradation Products