Conservative management of extra-axial hematomas diagnosed by CT

Our purpose was to assess the role of serial CT in recently traumatized patients with clinically stable extra-axial intracranial hematomas (EACH) and a midline shift of less than 0.5 cm. A retrospective review of 91 imaging studies in 41 patients (with 45 EACH) was done to assess the time between tr...

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Bibliographic Details
Published in:Neuroradiology 1999-12, Vol.41 (12), p.875-881
Main Authors: MUSZYNSKI, C. A, HAYMAN, L. A, WEINGARTEN, K, PROW, H. W, COLE, J. W, CONTANT, C. F
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Brain Edema - diagnostic imaging
Cerebral Hemorrhage, Traumatic - diagnostic imaging
Cerebral Hemorrhage, Traumatic - therapy
Child
Child, Preschool
Female
Humans
Infant
Injuries of the nervous system and the skull. Diseases due to physical agents
Male
Medical sciences
Middle Aged
Retrospective Studies
Skull Fractures - diagnostic imaging
Statistics, Nonparametric
Tomography, X-Ray Computed
Traumas. Diseases due to physical agents
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Summary:Our purpose was to assess the role of serial CT in recently traumatized patients with clinically stable extra-axial intracranial hematomas (EACH) and a midline shift of less than 0.5 cm. A retrospective review of 91 imaging studies in 41 patients (with 45 EACH) was done to assess the time between trauma and CT; the presence and type of skull fracture; the volume, type, and location of the EACH; the presence of associated edema and/or contusion. Over a 19-day follow-up, 11% of the dense EACH increased in volume and 27% decreased. An adjacent skull fracture was seen most frequently in patients with a decrease in EACH volume. Clinical data remain the key to determining the need for neurosurgical intervention in patients with EACH. Follow-up CT afforded no data which altered the medical management of these patients. However, it may be said to have alerted the clinician to an increase in the size of the EACH in 11% of cases, which could mandate close observation of this group.
ISSN:0028-3940
1432-1920
DOI:10.1007/s002340050859