Traumatic intracerebellar haematoma: To operate or not to operate?

Harsh, Viraat; Prakash, Anand; Barry, James M; Kumar, Anil

doi:10.3109/02688697.2014.987215

Cited by 8 publications

(13 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In accordance with previous studies on this topic our data showed GCS at initial presentation to be the most predictive clinical tool 5,6,7,21,23,25 . Domenico d'Avella et al 7 suggest that A GCS score of less than 8 was the most powerful adverse prognostic factor (58.78% probability of poor outcome as sole covariate) .…”

Section: Discussionsupporting

confidence: 92%

“…In this study fall from bike and pillan rider are the most common mechanism of injury. Bhardwaj et al has 15/21( 71.14%) 5 , Harsh et al has 15/23 ( 65.21%) 23 .…”

Section: Discussionmentioning

confidence: 99%

“…Total medial hematoma is 15 patients in which 7 patients had poor outcome (7/15-46.66%) and superficial hematoma in 45 patients in which only 4 patients has poor outcome (4/45-8.88%). It indicates that medial/deep hematoma has poor outcome 5,15,23 . In group A subgroup 1 st 7 patients has hematoma size > 3 cm and 5 worsened ( 5/7-71.42%) and then operated .. Subgroup 2 nd has size < 3 cm only 3 patient worsened (3/23-13.04%) , which is also due to midline position.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Traumatic isolated intracerebellar haematoma without any supratentorial lesion

Pintu¹,

Tarun²,

Jaiswal³

et al. 2020

roneuro

View full text Add to dashboard Cite

Purpose. Pure isolated cerebellar haematoma of traumatic aetiology, without associated posterior fossa sub- or epidural haematomas and without supratentorial bleed is a rare entity. We conducted this retrospective study to analyze the management strategy of isolated traumatic intracerebellar haematoma without supratentorial lesion in our institute. Methods. We retrospectively reviewed records of more than 15000 head injury patients in our department of neurosurgery between January 2014 and November 2019. In this isolated intracerebellar hematoma patients are 60. Patients were divided into two groups assessed by the GCS score at the time of presentation – Group A (GCS>13) Group B (GCS lesser than or equal to 13). Group A treated conservatively and B surgically. Group A subdivided according to the size of hematoma into1st (>3cm ) and 2nd (<3 cm ). Group B subdivided according to GCS into 1st ( <8 ) and 2nd ( 8-13). Results. Most Group B, subgroup 1st ( GCS<8) patients found to be associated with poorer outcome ( 60 %) and subgroup 2nd ( GCS 8-13) had only 10 %. Group A subgroup 1st ( > 3 cm hematoma) has associated with poor outcome ( 28.57%) and Subgroup 2nd ( < 3 cm ) has 4.34% . GCS score at the time of admission, hematoma size, hematoma location, the timing of surgery were important factors for outcome. Conclusion. We concluded that hematoma size is > 3 cm and GCS > 8 patient should operate within 12 hr. Patient of GCS < 8 results of surgery are poor( 60%.) .If the size of hematoma < 3 cm, lateral hematoma and GCS >13 should be treated conservatively. The factors which may be associated with the poor outcome are Low GCS score at the time of admission(<8), the large size of hematoma (>3cm), median location and delay time of surgery(>12hr).

show abstract

Section: Discussionsupporting

confidence: 92%

“…In this study fall from bike and pillan rider are the most common mechanism of injury. Bhardwaj et al has 15/21( 71.14%) 5 , Harsh et al has 15/23 ( 65.21%) 23 .…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Traumatic isolated intracerebellar haematoma without any supratentorial lesion

Pintu¹,

Tarun²,

Jaiswal³

et al. 2020

roneuro

View full text Add to dashboard Cite

show abstract

“…Bullock and Chang. [13], [14] had observed that ICP monitoring was tried in this study, but they observed that it was unable to predict the late onset sudden rise in pressure instead of ICP monitoring obliteration of basal cisterns pears to be more reliable indicator for severity of injury we agree with the observation of above study Virat Harsh et al and D. D'evella et al [15], [16] noted that the poor prognosis was observed in the patients having GCS-7 or below. In our study also, similar results were observed.…”

Section: Masseffectsupporting

confidence: 86%

A Study of Traumatic Intracerebral Haematomas in a Teaching Hospital of Central India

Ashok¹,

Mani²,

Babu³

2016

jemds

View full text Add to dashboard Cite

BACKGROUNDA study of 50 cases of Traumatic Intracerebral Haematomas was carried out to study the factors affecting management and prognosis. Incidence of Intracerebral Haematomas was more than other Intracranial Haematomas. Young male adults were affected most. Vehicular accident was the commonest mode of injury. Computed tomography was the definitive investigation. Hypertension, bradycardia and associated convulsions carried bad prognosis. Glasgow Coma Scoring was a good indicator of outcome. Commonest site was the Temporal Lobe, Multiple Haematomas and Haematomas involving Brainstem and Basal-Ganglia carried poor prognosis. Mortality was 61.53% and 33.3% in operated and non-operated groups respectively. Most small Haematomas (<15 mm on CT scan) were treated conservatively, whereas the large ones (>25 mm) surgically.

show abstract

“…Compared with traumatic brain injury, traumatic intracerebellar hemorrhage (TICH) has only a few small series of cases being reported [1][2][3][4][5]. Although TICH is a rare entity, it is associated with high morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Pre-operative External Ventricle Drainage Improves Neurological Outcomes for Patients with Traumatic Intracerebellar Hematomas

Bao

Guo

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Traumatic intracerebellar hematoma (TICH) is a very rare entity but with high morbidity and mortality rate, and there is no consensus on its optimal surgical management. In particular, whether and when to place external ventricle drainage in TICH patients without acute hydrocephalus pre-operation is still controversial.Methods: A single-institutional, retrospective analysis of total 47 TICH patients with craniectomy hematoma evacuation in a tertiary medical center from January 2009 to October 2020 was performed. Primary outcomes were mortality in hospital and neurological function evaluated by GOS at discharge and 6 months after the ictus. The special attention was paid to the significance of external ventricular drainage (EVD) in TICH patients without acute hydrocephalus on admission.Results: Analysis of the clinical characteristics of the TICH patients revealed that the odds use of EVD was seen in patients with IVH (p=0.03), fourth ventricle compression (p=0.02), and acute hydrocephalus (p<0.01). Placement of EVD at the bedside can significantly improve the GCS score before craniotomy (p=0.02), as well as the neurological score at discharge (p=0.045) and 6 months (p=0.04). Compared with the only hematoma evacuation (HE) group, there is a trend that EVD can reduce hospital mortality (27.6% vs. 38.9%) and decrease the occurrence of delayed hydrocephalus (4.8% vs. 18.2%), although the difference is not statistically significant. In addition, EVD can reduce the average NICU stay time (p=0.04, 4.9 ± 5.1 vs. 9.4 ± 6.3), but has no effect on the total length of stay. Moreover, our data showed that EVD did not increased the risk of associated bleeding and intracranial infection. Interestingly, in terms of neurological function at discharge and 6-month after the ictus (p=0.01), even though without acute hydrocephalus on admission, the TICH patients can still benefit from EVD insertion. Conclusion: For TICH patients, EVD is safe and can significantly improve neurological prognosis. Especially for patients whose GCS dropped by more than 2 points before operation, EVD can significantly improve the patient's GCS score, reduce the risk of herniation, and gain more time for surgical preparation. Even for TICH patients without acute hydrocephalus on admission CT scan, EVD placement still has positive clinical significance. However, future studies with larger sample size are warranted to confirm whether EVD can reduce in-hospital mortality and the risk of delayed hydrocephalus in TICH.

show abstract

Traumatic intracerebellar haematoma: To operate or not to operate?

Cited by 8 publications

References 21 publications

Traumatic isolated intracerebellar haematoma without any supratentorial lesion

Traumatic isolated intracerebellar haematoma without any supratentorial lesion

A Study of Traumatic Intracerebral Haematomas in a Teaching Hospital of Central India

Pre-operative External Ventricle Drainage Improves Neurological Outcomes for Patients with Traumatic Intracerebellar Hematomas

Contact Info

Product

Resources

About