Traumatic intracerebral haematomas of delayed onset

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Abstract
25 cases of traumatic intracerebral haematomas of delayed onset were found among 775 cases of acute head injuries. All these 25 cases were analysed both clinically and with computed-tomographical studies. Their clinical features were different from those of classical “traumatische Spät-Apoplexie” originally described by Bollinger in 1891, in the following aspects; (A) absence of the symptom-free interval and (B) absence of apoplectic onset of symptoms after a relatively long lucid interval. These traumatic intracerebral haematomas of delayed onset were, on the other hand, characterized by the following; (1) the patient was injured when the head was in motion, (2) the injury was not necessarily severe, (3) the onset of signs and symptoms were gradual and insidious, (4) all 25 cases but 4, had cranial vault fractures and/or basal skull fractures, (5) precipitating factors could not be identified, though hypotensive episodes were present in 60% of cases, (6) intracerebral haematomas appeared within 72 hours following the head injury in most of cases, though more than 4 days later in a small number of cases, (7) the appearance of such intracerebral haematomas suggested an unfavourable outcome, (8) cerebral contusion might be a major contributory factor.

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