Conservative Treatment for the Acute Stage Traumatic Intracranial Hematoma

Abstract

Widespread use of computed tomography (CT) has provided greater precision in the early diagnosis of the acute stage traumatic intracranial hematoma, enabling minor cases to be treated conservatively. In an effort to determine conditions under which conservative treatment is possible, 52 of 150 patients with acute stage traumatic intracranial hematoma, who exhibited a favorable course with conservative management were evaluated in detail. The patients who underwent conservative treatment comprised 7 cases with extradural hematoma, 18 with subdural hematoma, 24 with intracerebral hematoma and 3 with combined hematoma. The maximal amount of hematoma measured from CT scan was within 20 cm3 in extradural hematoma, within 7 cm3 in subdural hematoma and within 15 cm3 in intracerebral hematoma. The consciousness levels of all the patients were within 10 in each hematoma type after 3-3-9 scale during the course except for an initial few hours. Patients with acute stage traumatic intracranial hematoma, without definite local symptoms, and with a consciousness level within 10 should be treated conservatively, to avoid unnecessary craniotomy.