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. 2019 Jan:59:79-83.
doi: 10.1016/j.jocn.2018.10.149. Epub 2018 Nov 9.

The profile of blunt traumatic supratentorial cranial bleed types

Aaron C Shpiner  1 , Nikolay Bugaev  2 , Ron Riesenburger  3 , Isaac Ng  4 , Janis L Breeze  5 , Sandra S Arabian  6 , Reuven Rabinovici  7
Affiliations

The profile of blunt traumatic supratentorial cranial bleed types

Aaron C Shpiner et al. J Clin Neurosci. 2019 Jan.

Abstract

The characteristics of blunt traumatic supratentorial cranial bleed (STCB) types have not been directly compared. The National Trauma Data Bank (NTDB) 2014 was queried for adults with an isolated single STCB n = 57,278. Patients were grouped by STCB categories: subdural (SDH), subarachnoid (SAH), epidural (EDH), intraparenchymal (IPH), and intraventricular hemorrhage (IVH). Frequency, demographics, clinical characteristics, procedures, and outcomes were compared among groups. SDH was the most common STCB (53%) and occurred mostly in elderly patients after a fall (78%), 30% underwent craniotomy and their mortality was 7%. SAH occurred in 32% of patients and carried the lowest mortality (3%). SAH were least likely to have a severe brain injury (7%), and had the lowest Injury Severity Score (ISS, median 8) and complication rate (1%), as well as the shortest hospital length of stay (HLOS, 4.6 ± 6.4 days). EDH was uncommon (2%), occurred in younger patients (median 35 years), and had the highest percentage of traffic related injuries (28%). While EDH patients presented with the poorest neurological status (16% Glasgow Coma Scale ≤ 8, ISS median 18) and were operated on more than any other STCB type (51%), their mortality was lower (4%) and they had the highest discharge to home rate (71%). IVH was the least common (2%), but most lethal (9%) STCB type. These patients had the highest HLOS and intensive care unit LOS, and the lowest craniotomy rate (21%). STCB types have different clinical course, and outcomes. Understanding these differences can be useful in managing patients with STB.

Keywords: Intracranial bleed; Supratentorial bleed; Traumatic brain injury.

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Conflict of interest statement

Declarations of Interest:

There are no conflicts of interest to declare.

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