[Follow-up of computerized tomography findings in traumatic intracerebral hematomas].
Mo kle
Abstrè
CT controls and follow-ups were conducted in 27 patients who had suffered traumatic intracerebral hemorrhage. Only such patients were included who did not die before the 14th day after the trauma and in whom operation did not become necessary during this period. In these patients the volume of the hematoma and perifocal edema was determined via CT and clinical parameters were measured or recorded such as state of consciousness at the time of admission and the neurological outcome. It was found that the hematoma had attained its maximum size on about the fourth posttraumatic day. However, even the size of the freshly CT-detected hematoma shows good correlation to the outcome of the patients. Examination of the edema size points to the existence of two groups: one with only slight edema formation in the early posttraumatic stage, and another with an immediate considerable edematic border. From approximately the 8th posttraumatic day the hematoma/edema ratio is approximately the same in both groups, namely, 0.3. Anisocoria, or inequality of the pupils, occurred early in patients with an average hematoma volume of 37.7 cm. Of these, none left the hospital without neurologic signs, so that anisocoria must be considered as a prognostically unfavorable sign.