title: Surgical treatment of traumatic multiple intracranial hematomas.
abstract: OBJECTIVE
  To summarize our experience with the surgical treatment of traumatic multiple intracranial hematomas (TMIHs) and discuss the surgical indications.
  
  
  METHODS
  We analyzed the clinical data of 118 patients with TMIHs who were treated at the West China Hospital in Sichuan University, Chengdu, China between October 2008 and October 2011, including age, gender, cause of injury, diagnosis, treatment, and outcomes.
  
  
  RESULTS
  Among the 118 patients, there were 12 patients with different types of hematomas at the same site, 69 with one hematoma type in different compartments, and 37 with different types of hematomas in different compartments. In total, 106 patients had obliteration of basal cisterns, and 34 had a simultaneous midline shift >/=5 mm. Eighty-nine patients underwent single-site surgery, 19 had 2-site surgeries, and 10 patients did not undergo surgery. Based on the Glasgow Outcome Scale 6 months post-injury, 41 patients had favorable outcomes, and 77 had unfavorable outcomes. Basal cisterns obliteration was a strong indicator for surgical treatment. Single- or 2-site surgery was not related to outcome (p=0.234).
  
  
  CONCLUSIONS
  Obliteration of the basal cisterns is a strong indication for surgical treatment of TMIHs. After evacuation of the major hematomas, the remaining hematomas can be treated conservatively. Most patients only require single-site surgical treatment.
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University, No. 37 Guoxue Road, Chengdu 610041, China. Tel. +86 (138) 80719676. Fax. +86 (28) 85422490. E-mail: yangchaohua999@126.com.
authors.forename: Chaohua
authors.initials: C
authors.lastname: Yang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Cong
authors.initials: C
authors.lastname: Wu
authors.forename: Xin
authors.initials: X
authors.lastname: Zan
authors.forename: Chao
authors.initials: C
authors.lastname: You
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001925:Brain Damage, Chronic / Q000209:etiology / Q000517:prevention & control; D002648:Child; D002681:China; D003399:Craniotomy; D005260:Female; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019586:Intracranial Hypertension / Q000209:etiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult