Predictive indices in traumatic intracranial haematomas.

OBJECTIVE To identify factors of predictive value in the early diagnosis of traumatic intra-cranial haematomas (ICH). DESIGN A retrospective study of patients with positive exploratory burr hole findings of ICH. SETTING Jos University Teaching Hospital, Nigeria between January 1988 and December 1998. PATIENTS Two hundred and six patients. MAIN OUTCOME MEASURES The demographic data of patients, duration of presentation, Glasgow Coma Scale (GCS), causes, clinical features and mortality characteristics of patients were analysed. RESULTS There was a bi-modal age distribution with a mean of 26 years. Male:female ratio was 2:1. Vehicular accidents accounted for 72% of ICH and falls for 22%. Sixty seven per cent recorded a GCS of 14-15 out of a total of 175 GCS recorded. A brief history of loss of consciousness was obtained in 33%, headaches 49%, deterioration in conscious level 91%, seizures 53%, cranial nerve deficits 11% and hemiplegia in 22%. Significant lateralising signs occurred within 72 hours. Extra-dural haematomas constituted 37% and were associated with cranial vault fractures in all cases. Subdural haematomas constituted 60%, with skull fractures in eight per cent and intracerebral haematomas occurred in three per cent. A mortality of seven per cent was recorded for all patients with ICH. CONCLUSION Traumatic ICH is associated with raised intracranial pressure in many patients.