W e have recently treated three patients with delayed traumatic intracerebral hematomas. The hematomas were insignificant or not present on initial computerized tomography (CT) scans. Repeat CT scans obtained following neurological deterioration of the patients revealed hematomas of significant mass that required surgical evacuation. There have been a few case reports of delayed intracerebral hemorrhage, 9, 11 and only one previous case occurred within the first 24 hours after injury as happened with two of our patients. 3 Case Reports Case 1 This
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Delayed traumatic intracerebral hematomas
Report of three cases
Frederick D. Brown, Sean Mullan, and Eugene E. Duda
Traumatic intracerebral hematoma
Report of 63 surgically treated cases
Kenneth G. Jamieson and John D. N. Yelland
O f the three general types of intracranial hematomas that may complicate closed head injuries, those that are purely intracerebral are considerably less common than either extradural or subdural lesions. The 63 surgically treated cases reported here are drawn from approximately 11,000 admissions to the Royal Brisbane, Royal Children's, and Princess Alexandra Hospitals, Brisbane, in the 11 years from March, 1956, to March, 1967. Previous papers have reported 167 cases of extradural hematoma 3 and 553 of subdural hematoma 4 from the same 11,000 injuries
Experimental intracerebral hematoma
Reduction of oxygen tension in brain and cerebrospinal fluid
Bernard J. Sussman, Jesse B. Barber, and Harold Goald
surgical removal. It is known that intracranial hemorrhage associated with subarachnoid bleeding in man induces a severe reduction of CSF oxygen tension that is not necessarily related to increased intracranial pressure. 24 This finding and the aforementioned considerations have led the authors to reevaluate intracerebral hematoma by experimental simulation in acute and short-term canine preparations. Method Experiment 1: Prolonged Measurement of Changes in the pH, pO 2 , pCO 2 of the Blood and CSF Under intravenous sodium pentobarbital anesthesia
Eugenio Pozzati, Giuliano Giuliani, Giulio Gaist, Giancarlo Piazza, and Gilberto Vergoni
intracerebral hematomas Case No. Age (yrs), Sex Symptoms Computerized Tomography Findings Surgical Findings * Outcome Density Ring Blush Edema Location 1 66, F headache, papilledema mixed yes yes parieto-occipital chronic encapsulated hematoma recurrent hematoma, dead 2 11, M seizures mixed yes yes frontoparietal chronic encapsulated hematoma good 3 16, F aphasia, rt hemiparesis hyperdense no yes temporal liquefied hematoma, AVM disabled 4 36, M
Neurosurgical Forum: Letters to the Editor To The Editor Dimitris Antoniou , M.D. Iaso General Hospital Athens, Greece 582 582 Abstract Object. The aim of this study was to evaluate the efficacy of a treatment combination of coil embolization and clot evacuation in patients presenting with an intracerebral hematoma (ICH) caused by the rupture of an aneurysm. Methods. Twenty-seven patients were prospectively recruited in this study between 1996 and 2000. Endovascular treatment of the putative ruptured
Toshikazu Masuda, George J. Dohrmann, Hau C. Kwaan, Robert K. Erickson, and Robert L. Wollman
L ittle is known about the mechanism and importance of fibrinolytic resolution of intracerebral hematomas. In general, clot lysis depends on fibrinolysis and phagocytosis. It is known that phagocytosis is carried out by macrophages derived from neighboring capillaries and that the participation of microglia is minor in the removal process. 13 The fibrinolytic activity in tissue is caused by an activator which converts plasminogen, a protease precursor in blood, to the fibrin-digesting protease, plasmin. 1, 15 Little or none of the free plasmin, the active
Delayed traumatic intracerebral hematomas: “Spät-Apoplexie”
Report of two cases
Henry Elsner, Daniele Rigamonti, Gregory Corradino, Robert Schlegel Jr., and John Joslyn
.01210010004001 4. Diaz FG , Yock DH Jr , Larson D , et al : Early diagnosis of delayed posttraumatic intracerebral hematomas. J Neurosurg 50 : 217 – 223 , 1979 Diaz FG, Yock DH Jr, Larson D, et al: Early diagnosis of delayed posttraumatic intracerebral hematomas. J Neurosurg 50: 217–223, 1979 10.3171/jns.1979.50.2.0217 5. Dohrman PJ , Siu KH , Pike J : Delayed traumatic intracerebral haematoma: case report. Aust NZ J Surg 53 : 169 – 171 , 1983 Dohrman PJ, Siu KH, Pike J: Delayed
Edward I. Kandel and Vjacheslaw V. Peresedov
I n 1978, Backlund and von Holst 1 proposed a new principle of stereotaxic subtotal removal of intracerebral hematomas in which a special instrument with a mandrel-like Archimedes screw inside a cannula is used to destroy and remove dense clots. We have improved on this promising method and have designed instrumentation for use in this operative procedure. In this paper, we describe the device and its use in 32 cases of spontaneous intracerebral hematoma, including one case caused by aneurysmal rupture and one secondary to rupture of an arteriovenous
Fernando G. Diaz, Douglas H. Yock Jr., David Larson, and Gaylan L. Rockswold
D elayed intracerebral hematoma following craniocerebral injury is an established clinical syndrome that generally occurs after a severe head injury with the head in motion. It is usually characterized by the appearance of focal neurological signs or depression of the level of consciousness, developing days or weeks after trauma. 2, 4, 6, 15, 18 Prompt diagnosis is necessary to minimize the harmful effect that the hematoma exerts on the already traumatized brain, 2, 4, 10, 17 to favor clinical recovery, 4, 15, 19, 21 and to prevent a fatal outcome. 6, 18
Role of surgery in hypertensive intracerebral hematoma
A comparative study of 305 nonsurgical and 154 surgical cases
Tetsuo Kanno, Hirotoshi Sano, Youichi Shinomiya, Kazuhiro Katada, Junji Nagata, Masaaki Hoshino, and Fuyuki Mitsuyama
H ypertensive intracerebral hematoma (ICH) is a serious and potentially lethal condition. The introduction of computerized tomography (CT) has made early diagnosis simple and easy, which has led to changing concepts in the management of ICH's. The enthusiastic surgical removal of all types of ICH has resulted in a disappointing overall prognosis. Various factors contributing to a better prognosis are being studied with the help of the ever-increasing array of diagnostic aids and methods. 4 One of the most important factors influencing the prognosis is proper
