Recurrent hematomas following craniotomy for traumatic intracranial mass

R. Bullock, C. O. Hannemann, L. Murray, G. M. Teasdale

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

Of 850 patients who underwent craniotomy for evacuation of a traumatic intracranial mass, 59 (6.9%) developed a second hematoma at the operation site, which required a second operation. Compared to those who did not, patients who developed postcraniotomy hematoma (PCH) had a significantly higher incidence of evidence of alcohol intake and preoperative mannitol administration; a higher percentage had a bad outcome. Coagulopathy was frequent in PCH patients. Although three-quarters of the initial hematomas were intradural, 69% of the PCH's were predominantly extradural. The large potential space underlying a craniotomy bone flap may predispose to development of a PCH. Intracranial pressure (ICP) was monitored in 39 of the 59 PCH patients, which allowed earlier detection of the PCH in 22 (56%). In 17 patients, the ICP failed to rise despite clinical deterioration, and detection of the PCH was delayed, significantly worsening the outcome in this group.

Original languageEnglish (US)
Pages (from-to)9-14
Number of pages6
JournalJournal of neurosurgery
Volume72
Issue number1
DOIs
StatePublished - Jan 1 1990

Keywords

  • Head injury
  • intracranial hematoma
  • outcome
  • postcraniotomy hematoma

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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