Intracerebral Hematoma

Intracerebral hematoma is a fairly frequently occurring condition and a comprehensive review of the incidence, etiology, and treatment of this type of hematoma has been presented by Craig and Adson.' Although as early as 1903 Cushing4 reported the successful evacuation of an intracerebral dot, only sporadically since then have cases of successful surgical treatment of this type of hematoma been recorded. In that group of cases, however, in which surgical treatment has been successful both the spontaneous and traumatic varieties of the lesion have been represented (Penfield,7 Bagley,' and, more recently, Doughty5). The widespread impression that the intracerebral hemorrhage, usually regarded as fatal (Robinson8), is scarcely amenable to surgical treatment probably has been influenced by the following considerations: 1. The frequently occurring and deeply lying hematomas which directly sever fiber tracts of the internal capsule cause irreparable damage which, theoretically at least, may be increased by surgical efforts at removal of the clot (Bagley'). 2. Relief from operation, when it has been obtained, has been regarded usually as only temporary (Penfield7). 3. The fear of recurrent bleeding, especially after early operation as noted by Naffziger,6 probably has further weakened in the minds of many the indications for operative intervention. A provisional diagnosis of subdural clot or brain neoplasm has in many instances led to the successful evacuation of an intracerebral hematoma. Penfield7 has expressed the opinion that more careful case study may open an avenue of help for a larger number of patients in this group. The following case is reported as the successful surgical removal of an intracerebral hematoma, probably traumatic in origin.