Journal of Trauma and Injury

  • 제23권2호
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  • Pages.142-150
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  • 2010
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  • 2799-4317(pISSN)
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  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지

초기 두부외상 기간 동안 지속적 외상성 뇌실질내 혈종에 관계되는 위험인자

Risk factors related to progressive traumatic intracerebral hematomas in the early post head injury period

  • 이영배 (동국대학교 의과대학 신경외과학교실) ;
  • 정휘수 (동국대학교 의과대학 가정의학교실)
  • Lee, Young-Bae (Department of Neurosurgery, Dong-guk University Gyeongju Hospital) ;
  • Jeong, Hwee-Soo (Department of Family Medicine, Dong-guk University Gyeongju Hospital)
  • 투고 : 2010.09.29
  • 심사 : 2010.11.15
  • 발행 : 2010.12.30
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초록

Purpose: In this study, patients in whom two computed tomography (CT) scans had been obtained within 24 hours of injury were analyzed to determine the incidence, risk factors and clinical significance of a progressive intracerebral hematoma (PIH). Methods: Participants were 182 patients with a traumatic intracerebral hematoma and contusion who underwent a repeat CT scan within 24 hours of injury. Univarite and multivariate statistics were used to define growth (volume increase) and to examine the relationship between the risk factors and hemorrhage expansion. Results: Fifty-four percent of the patients experienced progression in the size of the lesion in the initial 24 hours postinjury. A PIH was independently associated with worsened Glasgow coma scale (GCS) score (2.99, 1.04~8.60), the presence of subarachnoid hemorrhage (6.29, 2.48~16.00), the presence of a subdural hematoma (6.18, 2.13~17.98), the presence of an epidural hematoma (5.73, 1.18~27.76), and the presence of a basal cistern effacement (10.93, 1.19~99.57). Conclusion: For patients undergoing scanning within 2 hours of injury, the rate of PIH approaches 61%. Early repeated CT scanning is indicated in patients with a nonsurgically-treated hemorrhage revealed on the first CT scan. Worsened GCS score, significant hematoma growth and effacement of the basal cisterns on the initial CT scan are powerful predictors of which patients will require surgery. These findings should be important factors in understanding and managing of PIH.

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