INDICATIONS FOR SURGERY IN SPACE-OCCUPYIN G CONTUSION-INDUCED HEMATOMAS

Traumatic intracerebral haematomas are a common neurosurgical emergenc y. The role of surgical removal is controversial. The diagnosis and tr eatment of life-threatening thoracic or abdominal haemorrhage is more urgent than are measures undertaken by the neurosurgeon. In the presen t paper we report on 318 patients with severe head injury. In 161 case s (38 female, 123 male) CT investigation showed a a resulting from con tusion. About a third of each group of patients, both with and without contusion-induced haematomas, were 2130 years old. The mortality rate was 18.6 %. Multiple contusion haematomas occurred in 36 %, and solit ary ones in 64 %. The diagnostic investigations showed contusion haema tomas in isolation only in 10.6 % of patients. All others had addition al injuries: epidural haematomas in 24 cases, subdural haematomas in 2 9, depressed fractures of the skull in 6, and traumatic subarachnoid h aemorrhage in 37. Only 10 patients underwent operative removal of thei r contusion haematomas by trepanation and 2 others by stereotactic pun cture.