Experience and treatment of progressive hemorrhagic injury after traumatic brain injury

Abstract

Objective To investigate the clinical feature of progressive hemorrhagic injury (PHI) after traumatic brain injury and to summarize the pathogens of PHI and to investigate the method of timely diagnosis, timely treatment for PHI. Methods One hundred and sixty seven cases of PHI after traumatic brain injury which admitted in our hospital from Jan 2015 to Jun 2017 were analysed retrospectively. According to GCS scores of 167 cases of PHI after traumatic brain injury on admission: 3-5 points in 11 cases, 6-8 points in 36 cases, 9-12 points in 83 cases, 13-15 points in 37 cases. All patients expressed the symptom of increased intracranial pressure in different degrees. During observation and treatment, 76 cases expressed disorder of consciousness or consciousness obstacle deepened, 94 cases expressed limb strength weakening, 81 cases vomited frequently, 43 cases with restlessness, 5 cases with brain hernia. Results The 94 patients were performed operation and the 108 patients were performed conservative care. According GOS score to judge: surgical outcome were good in 114 cases, light disability in 32 cases, severe disability in 13 cases and dead in 8 cases. The total mortality rate is 4.8%. Conclusion The early diagnosis of PHI after traumatic brain injury depends on the doctor’s vigilance. The follow-up of CT scan of head was effective method to find the PHI. It is mistaken to draw up an invariable cure plan only according to the first CT scan of head for the patients who suffer from traumatic intracranial hematoma. It is right to regulate the cure plan according to the changes of the patient’s hematomas and observe the changes of patients and to supervise the CT scan of head. Key words: Traumatic brain injury; Progressive hemorrhagic injury; Consciousness disorder