Clinical significance of progressive traumatic intracranial hematomas in acute period of traumatic brain injury

This work is devoted to one of the topical issues of neurosurgery, namely, craniocerebral injuries, in particular, intracranial hematomas. Timely diagnosis of traumatic intracranial hematomas and the choice of a correct treatment strategy are the main factors of patient's recovery. The purpose of the study was to monitor intracranial hematomas and their changes using neuroimaging of brain structures, and to evaluate brain CT and MRI efficacy in a hospital setting. Materials and Methods. The authors analyzed 2255 medical records of patients treated in the neurosurgical departments of Ulyanovsk Regional Clinical Center for Specialized Types of Medical Care named after E.M. Chuchkalov and Central City Clinical Hospital, 61 reports of forensic autopsies and 373 surgical reports. Surgical procedures were performed in 2015. Results. Intracranial hematomas were diagnosed in 198 patients (8.7 %). According to the time factor, the hematomas were distributed as follows: 150 acute (75.8 %); 35 subacute (17.7 %); 8 chronic (4.0 %). In five cases (2.5 %), the authors identified hematomas that were not registered in the existing classification. Such hematomas have not been adequately investigated yet. Such hematomas were called “progressive", due to their increase in case follow-up. Conclusion. The peculiarities of “progressive" intracranial hematoma development necessitates clinical suspicion. In this regard, the pathology requires a more detailed study in order to create a system of clinical and neuroimaging monitoring and develop management guidelines.