RISK-FACTORS PREDICTING SURGICALLY SIGNIFICANT INTRACRANIAL HEMATOMASIN PATIENTS WITH HEAD-INJURIES

This population-based study was designed to determine the risk of pati ents with head injuries to develop surgically significant intracranial hematomas (SSIHs). A total of 28,500 cases of head injury were review ed in Taipei City and Hualien County from 1988 to 1999. The Glasgow Co ma Scale (GCS) was used to determine the severity of head injury. The presence of skull fracture and intracranial hematoma was determined by x-ray and computed tomographic (CT) scan, respectively. Those patient s suffering from both loss of consciousness and skull fracture had a s ignificantly greater risk of developing SSIHs than those having no ne or only one of these conditions. The relationship between skull fractu re and severity of head injury revealed that the presence of a skull f racture in mildly head-injured patients could be used as an indicator to investigate the development of SSIHs before the occurrence of irrev ersible damage. The distribution of hematomas by location showed that a higher rate of SSIH resulting in parenchymal damage occurred when co nsciousness was lost. It also showed that epidural hematomas occurred more frequently with skull fractures. Skull fracture and impaired cons ciousness are important indices in determining the risk of developing SSIH.