Traumatic intracerebral hematomas--diagnostic and therapeutic problem.
A retrospective analysis was performed of 79 patients with hematomas treated surgically or conservatively. The surgical modality was most often opted for in the following cases: patients with hematomas exceeding 4 cm in diameter; patients with hematomas causing a pronounced dislocation of cerebral structures; patients with multiple hematomas that can be accessed through a bone flap. Hematomas smaller than 4 cm in diameter as well as those located in several brain regions were found to tend easily to resorption at the control computer tomography due to which we preferred treating them using conservative therapeutic methods. This therapeutic approach to the patients with hematomas is supported by the statistical analysis. Comparison of the groups of survivors and nonsurvivors shows that the former predominated in cases of hematomas located in the frontal lobe; the latter are predominant when the hematomas are located in the temporal lobe of the brain. There was no difference between the groups of surgically and conservatively treated patients with respect to the outcome of the disease if it is improvement or death. In the group of patients who underwent conservative treatment there was a predominance of those patients that showed no improvement of the initial state. The following conclusions can be made: 1. Surgical treatment is most often administered to patients with hematomas greater than 4 cm in diameter and hematomas causing dislocation of the cerebral structures. 2. The patients at highest risk for adverse outcome are those with temporal location of the hematoma.
Kumchev
Y
Y
Department of Neurosurgery, Higher Medical Institute, Plovdiv, Bulgaria.
Dimitrov
Z
Z
Kalnev
B
B
Argirov
S
S
D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006259:Craniocerebral Trauma / Q000150:complications*; D006406:Hematoma / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D016896:Treatment Outcome