Clinical characteristics of postoperative contralateral intracranial hematoma after traumatic brain injury.
OBJECTIVE
To investigate the clinical characteristics of contralateral intracranial hematoma (ICH) after traumatic brain injury.


METHODS
The subjects included 149 patients with traumatic ICH treated by hematoma evacuation. The patients were retrospectively divided into a bilateral ICH (B-ICH) group and unilateral ICH (U-ICH) group after craniotomy using brain CT scans for comparison of the following parameters: complicated expanded brain bulk from the cranial window, hypotension during craniotomy, and outcome.


RESULTS
Post-craniotomy brain CT scans revealed U-ICH in 106 patients and B-ICH in 43 patients. Average Glasgow Coma Scale on arrival did not differ between the groups, but a higher proportion of patients in the B-ICH group deteriorated after admission (p = 0.02). The B-ICH patients also exhibited a significantly higher rate of expanded brain bulk from the cranial window (p < 0.05). No significant difference was observed between the groups with hypotension during craniotomy. The B-ICH group exhibited a lower rate of favorable outcome (p < 0.05) and higher mortality (p < 0.05).


CONCLUSIONS
The B-ICH patients had a worse outcome than the U-ICH patients. Contralateral ICH was difficult to forecast based on pre- and intraoperative clinical conditions. Subdural hematoma or contusional ICH was frequently observed as a contralateral ICH.
Furukawa
M
M
Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Tokyo, Japan. makotof@med.nihon-u.ac.jp
Kinoshita
K
K
Ebihara
T
T
Sakurai
A
A
Noda
A
A
Kitahata
Y
Y
Utagawa
A
A
Moriya
T
T
Okuno
K
K
Tanjoh
K
K