[Traumatic delayed intracerebral hematoma--clinical aspects].

In order to seek the occasion and the management of traumatic delayed intracerebral hematoma, we selected 17 cases (4.2%) of traumatic delayed intracerebral hematoma (secondary lesion) from 401 cases of head injury, and compared them with other 11 acute traumatic intracranial multiple lesion (immediate lesion). The age ranged from 15 to 78 (except for a newborn hit on the cranium by his mother) and the average was 49 in secondary lesion and 58 in immediate lesion. Sex distribution, 15 males and 2 females in secondary lesion, and 10 males and 1 female in immediate lesion. Though both lesions were supposed to be resulted from almost same severe loads, secondary lesion took worse prognosis than the other: misery outcome (poor and fatal) of secondary lesion was 59% and that of immediate lesion 27%. Of 8 hypertensive cases who were all fatal, 7 were of secondary lesion. Secondary lesion could be expected in only 59% (10/17) by the initial X-CT performed 5.4 +/- 6.2 hr. after trauma. The predicted secondary lesion were classified into three types: salt and pepper like high density lesion (Lanksh's II type), low density lesion (Lanksh's I type) and isodensity mass lesion. The shortest interval between injury and the X-CT detection of secondary lesions was 10 hours and the longest interval was 69 hours (40 hours mean) in conservatively treated patients. In operated patients, the shortest and longest intervals were 8 and 84 hours, respectively (33 hours mean, except for one case who was not examined for 10 days after operation).(ABSTRACT TRUNCATED AT 250 WORDS)