J Korean Soc Emerg Med.  1998 Dec;9(4):636-644.

Acute Traumatic Intracranial Hematoma: Mortality and Operative timing

• Kim KT

Abstract

To discover the effects of the time from injury to operative evacuation of the acute intracranial hematoma in the regard to improve outcome mortality, we reviewed the records 90 traumatic patients with acute intracrainal hematoma treated at our hospital between 1996 and 1997. The overall mortality late was 50%. The important prognostic variables included Glasgow coma scale(GCS), age, degree of midline shift in computerized tomography(CT), and lesional type of hematoma. Outcome was not significantly improved by rapid surgical decompression and no benefit revealed when surgery was performed within fast 4 hours. The mean interval from injury to surgery was 411 minutes for patient who died and 404 minutes for patients with functional recovery, but it was statistically insignificant. the mortality rate for those patients operated on within 4 hours of injury was 44% versus 52.3% for those operated on after 4 hours, and it was also statistically insignificant. In our opinion impart brain damage may be substantial and will affect recovery from intracranial hematoma and the operative timing-within the first 4 hours-may not be critical as has been commonly held.

MeSH Terms

Brain
Coma
Decompression, Surgical
Hematoma
Humans
Intracranial Hemorrhage, Traumatic*
Mortality*