title: A case report of successful conservative treatment for huge acute traumatic intracerebral hematoma.
abstract: Acute traumatic intracerebral hematoma (ICH) is a common intracranial injury after trauma. Surgery is preferred if the volume of supratentorial hematoma is >30 mL and complicated with disturbance of consciousness or other neurofunction impairment. When supratentorial hematoma is >50 mL, patients can rarely survive if only treated with medicine. Here we present a successful case of conservative treatment for an elderly female patient with acute traumatic ICH of about 80 mL. The patient was admitted to the emergency department, with a complaint of conscious disturbance for half a month after occipital injury. A diagnosis of left prefrontal lobe cerebral contusion complicated with ICH was made after computed tomography (CT) scan. She was then treated with mannitol and dexamethasone, which were reduced stepwise for 65 and 15 days in total, respectively. The hematoma and the surrounding edema have been gradually absorbed. Eventually, she was transferred to the local hospital for rehabilitation. This report may provide additional experience on the conservative treatment for elderly patients with large ICH, which, however, needs to be evaluated carefully in different clinical settings. In addition, the younger patients in better clinical condition are still suggested to receive operation.
authors.affiliation: From the Department of Neurosurgery (ZG, QD, CL, RZ, SG); Department of Ultrasound (LS); and Department of Emergency Medicine (GW), The Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Guo
authors.forename: Lu
authors.initials: L
authors.lastname: Sun
authors.forename: Quan
authors.initials: Q
authors.lastname: Dong
authors.forename: Chongxiao
authors.initials: C
authors.lastname: Liu
authors.forename: Ren
authors.initials: R
authors.lastname: Zhou
authors.forename: Shouping
authors.initials: S
authors.lastname: Gong
authors.forename: Gang
authors.initials: G
authors.lastname: Wang
mesh_terms: D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D054022:Cerebrum; D003907:Dexamethasone / Q000627:therapeutic use*; D004234:Diuretics, Osmotic / Q000627:therapeutic use*; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D008353:Mannitol / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D000893:Anti-Inflammatory Agents; D004234:Diuretics, Osmotic; D008353:Mannitol; D003907:Dexamethasone