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Predictive indices in traumatic intracranial haematomas
Abstract
Objective: To identify factors of predictive value in the early diagnosis of traumatic intra-cranial haematomas (ICH).
Design: A retrospective study of patients with positive exploratory burr hole findings of ICH.
Setting: Jos University Teaching Hospital, Nigeria between January 1988 and December 1998.
Patients: Two hundred and six patients.
Main outcome measures: The demographic data of patients, duration of presentation, Glasgow Coma Scale (GCS), causes, clinical features and mortality characteristics of patients were analysed.
Results: There was a bi-modal age distribution with a mean of 26 years. Male: female ratio was 2:1. Vehicular accidents accounted for 72% of ICH and falls for 22%. Sixty seven per cent recorded a GCS of 14-15 out of a total of 175 GCS recorded. A brief history of loss of consciousness was obtained in 33%, headaches 49%, deterioration in conscious level 91%, seizures 53%, cranial nerve deficits 11% and hemiplegia in
22%. Significant lateralising signs occurred within 72 hours. Extra-dural haematomas constituted 37% and were associated with cranial vault fractures in all cases. Subdural haematomas constituted 60%, with skull fractures in eight per cent and intracerebral haematomas occurred in three per cent. A mortality of seven per cent was recorded for all patients with ICH.
Conclusion: Traumatic ICH is associated with raised intracranial pressure in manypatients.
Design: A retrospective study of patients with positive exploratory burr hole findings of ICH.
Setting: Jos University Teaching Hospital, Nigeria between January 1988 and December 1998.
Patients: Two hundred and six patients.
Main outcome measures: The demographic data of patients, duration of presentation, Glasgow Coma Scale (GCS), causes, clinical features and mortality characteristics of patients were analysed.
Results: There was a bi-modal age distribution with a mean of 26 years. Male: female ratio was 2:1. Vehicular accidents accounted for 72% of ICH and falls for 22%. Sixty seven per cent recorded a GCS of 14-15 out of a total of 175 GCS recorded. A brief history of loss of consciousness was obtained in 33%, headaches 49%, deterioration in conscious level 91%, seizures 53%, cranial nerve deficits 11% and hemiplegia in
22%. Significant lateralising signs occurred within 72 hours. Extra-dural haematomas constituted 37% and were associated with cranial vault fractures in all cases. Subdural haematomas constituted 60%, with skull fractures in eight per cent and intracerebral haematomas occurred in three per cent. A mortality of seven per cent was recorded for all patients with ICH.
Conclusion: Traumatic ICH is associated with raised intracranial pressure in manypatients.
