Multiple intracranial hematoma

Introduction to multiple intracranial hematoma When two or more different parts or types of hematoma are formed in the skull after craniocerebral injury, it is called multiple hematoma. Such hematoma is often associated with severe brain contusion and laceration, accounting for 14.4% to 21.4% of intracranial hematoma, of which 60% are in different parts; hematomas are located in the same area but not the same type. About 40%. Multiple hematoma does not have unique clinical signs. Although preliminary estimates can be made based on the mechanism of injury and neurological impairment, symptoms and signs are often confused between various multiple hematomas. It is difficult to diagnose and often rely on imaging. The examination, or confirmed by surgical exploration. basic knowledge The proportion of illness: 0.03% Susceptible people: no specific people Mode of infection: non-infectious Complications: subdural hematoma

Causes of multiple intracranial hematoma

Causes:

Many of the heads are directly hit by external forces, resulting in deformation or fracture of the skull at the point of force, which is caused by blood vessels. The formation mechanism is similar to that of the contusive brain contusion. Therefore, its location is mainly located in the frontal and temporal lobes, accounting for 80% to 90% of the total. 10% to 20% of parietal or occipital hematoma is caused by shock or depression caused by direct violence. A small number of deep hematoma or brain stem hematoma caused by shearing in the brain. 30% of patients may have multiple intracerebral hematomas, of which different parts account for about 60%, and different types in the same part account for about 40%. 30% to 60% of all intracerebral hematoma patients have extracerebral hematoma.

Multiple intracranial hematoma prevention

The disease is a traumatic disease, no preventive measures, pay attention to safety, avoid trauma, once the brain trauma should be diagnosed as early as possible, early treatment. Patients with a history of traumatic brain injury should closely monitor intracranial pressure. Once the intracranial pressure is increased, it is necessary to diagnose multiple intracranial hematoma as soon as possible. If symptoms and general clinical indications cannot be diagnosed, CT scan should be used to diagnose and diagnose as early as possible. Make treatments. Such as medical treatment or surgical treatment.

Multiple intracranial hematoma complications Complications subdural hematoma

The disease is often associated with other single hematoma, such as intracerebral hematoma, subdural hematoma.

Multiple intracranial hematoma symptoms Common symptoms Skull continuity interrupted crush injury coma

Multiple hematoma does not have unique clinical signs. Although preliminary estimates can be made based on the mechanism of injury and neurological impairment, symptoms and signs are often confused between various multiple hematomas. It is difficult to diagnose and often rely on imaging. The examination, or confirmed by surgical exploration, is generally divided into three cases:

1. Multiple hematomas of different types in the same site, mostly for contusive brain contusion with acute subdural hematoma and intracerebral hematoma; or for epidural hematoma with local subdural and/or intracerebral hematoma.

2. Multiple hematoma of the same type in different parts, often bilateral subdural hematoma, especially in children and elderly patients, due to deceleration injury of the frontal or occipital, when the injury is violent, the brain contusion is severe , often acute subdural hematoma, often located in the front of the bilateral frontal frontal, if the primary brain injury is mild, the bridge surface of the brain surface tear bleeding, mostly chronic or subacute bilateral hemispherical convex dura mater Hematoma, occasionally due to crush injury caused bilateral fractures of the tibia, but also the possibility of bilateral epidural hematoma, but less common.

3. Different types of multiple hematoma in different parts, seen in the hard part of the epidural hematoma and / or intracerebral hematoma with hemorrhage in the subdural and intracerebral hematoma, sometimes occipital deceleration injury, causing occipital bone fracture, can cause posterior cranial fossa Epidural hematoma, with subdural and / or intracerebral hematoma in the hedging area, the clinical manifestations of such hematoma are often more serious, the patient continues to coma after the injury or the change of consciousness disorder is rapid, easy to appear early canopy incision and bilateral cone Body bundle damage sign.

Examination of multiple intracranial hematoma

When multiple hematoma is suspected, an auxiliary examination such as CT, MRI or cerebral angiography should be performed early to confirm the diagnosis. The X-ray film of the skull can indicate whether there is a fracture line crossing the sinus or vascular sinus. Ultrasound detection If the midline wave is not displaced or slightly offset and does not match the clinical signs, multiple hematoma should be considered. If the cerebral angiography shows no vascular area, the anterior cerebral artery does not move to the opposite side. When the position, or the degree of displacement is less than 1/2 of the original hematoma, or when the hematoma is very small and the midline shift is too large, the possibility of multiple hematoma should be thought of.

Diagnosis and diagnosis of multiple intracranial hematoma

Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.

Different from single hematoma, the disease is complicated in the way of injury; multiple scalp injuries or multiple skull fractures; presence of contralateral brain injury; intracranial pressure is not reduced after surgical removal of a hematoma, or once reduced Elevated; CT scan confirmed the presence of a hematoma on one side, but the midline shift did not match the CT findings.

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