Delayed Posttraumatic Hemorrhage

Abstract

Background and Purpose Delayed posttraumatic hemorrhage (DPTH) is one of the causes of intracerebral hemorrhage (ICH). Most of the published series were reported before the advent of CT. Clinical characteristics and CT findings are described. Methods Ten cases of CT-proven DPTH from a series of 216 patients (age range, 15 to 50 years) with ICH were evaluated. Previous CT scans performed in the first 6 hours after head injury were normal in all patients. Cerebral angiography showed no evidence of vascular disorders in any patient. Results DPTH was the fourth most common cause of ICH in our series. The symptom-free interval after head injury ranged from 1 to 15 days. Most hematomas were located deep in the hemisphere and were of small or medium size. Clinical course was good in the majority of cases; none of the patients died, and there was no recurrence. Conclusions DPTH is a relatively frequent cause of ICH in young adults. There is no relationship with intensity of the previous head injury. The more frequent location deep in the hemisphere may be related to the younger age of our patients compared with those of other published series. The good outcome in our patients may be related to their youth and the absence of complications such as skull fracture, need for neurosurgery, or coagulation disorders.