Pitfalls in The Management of Delayed Extradural Hematoma in Polytrauma Patients

Hong, Soon Ki; Kim, Hun Joo; Han, Yong Pyo

J Korean Soc Emerg Med > Volume 1(1); 1990 > Article

Journal of The Korean Society of Emergency Medicine 1990;1(1): 111-116.

ABSTRACT

It is well known that a large number of patients die, not because of primary brain damage, but also entirely because of secondary brain insults that occur following polytrauma. Of special concern is identification and anticipation of those preventable and correctable factors that cause further damage to the already injured brain. For the past one year, we have encountered polytraumatized patient with delayed extradural hematoma, resuiting in variable outcome. These following comments below should be emphasized as a guidelines of prevention against delayed onset of intracranial mass lesion on polytrauma patients. 1. Delayed onset of intracranial mass lesion should be much more frequent in victims of fall than in patients with vehicular injuries. 2. The treatment regimen such as fluid replacement for hemorrhagic shock, osmotherapy and hyperventilation might induce delayed intracranial hematoma to a sizeable lesion to render patients life dangerous. 3. Brain CT scan study, especially in case of polytrauma patients, should be repeated as many as possible, preoperatively and immediately after postoperative period.