Bedside catheter evacuation of predominantly isolated traumatic supratentorial hemorrhage.
BACKGROUND
Predominantly isolated intracerebral hemorrhage (ICH) is a rare complication after traumatic brain injury that tends to occur in patients with coagulation disorders.


METHODS
We developed a minimally-invasive free-hand bedside catheter evacuation procedure using 3D-computerized tomography reconstruction imaging. Twelve patients were retrospectively analyzed.


RESULTS
Average duration of the procedure was approximately 15 minutes. After catheter placement, urokinase-lysis ensured successful hemorrhage evacuation. Mean Glasgow coma scale at admission was 10 and mean hemorrhage diameter was 6.3 x 3.9 x 4.2 cm, or 55 mL. Mean hemorrhage reduction was 37 mL or 66% in a mean of 4 days. No catheter-related complications were observed. The 30-day and 6-month mortality rates were 16%. Mean extended Glasgow outcome scale at discharge was 4. After a mean of approximately 19 months, nine patients had a favorable, two an unfavorable outcome. One was lost to follow-up.


CONCLUSIONS
In comparison with previously published results, free-hand bedside catheter evacuation is a quick and easy-to-apply technique to evacuate predominantly isolated traumatic supratentorial hemorrhage that can be performed in any intensive care unit.
Deininger
Martin H
MH
Department of Neurosurgery, University of Freiburg Medical School, Freiburg, Germany. martin.deininger@uniklinik-freiburg.de
Adam
Abbas
A
Van Velthoven
Vera
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000150:complications*; D002404:Catheterization; D020202:Cerebral Hemorrhage, Traumatic / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult