CLINICAL, DIAGNOSTIC, AND SURGICAL ASPECTS OF BILATERAL MULTIPLE TRAUMATIC INTRACRANIAL HEMATOMAS

Abstract

Background. Bilateral multiple traumatic intracranial hematomas represent one of the most severe forms of traumatic brain injury, associated with high mortality, significant neurological deficits, and considerable challenges in surgical decision-making.

Objective. To identify clinical features, neuroimaging characteristics, and surgical management strategies for bilateral multiple traumatic intracranial hematomas.

Materials and methods. A total of 117 patients with multiple traumatic intracranial hematomas were analyzed, including 49 cases with bilateral hemispheric involvement. All patients underwent detailed neurological examination, skull radiography, and brain computed tomography.

Results. Bilateral hematomas were most commonly associated with a coup–contrecoup mechanism of injury. Focal neurological deficits predominated contralateral to the larger hematoma. Anisocoria was usually mild, and midline shift was uncommon. Surgical tactics were primarily guided by hematoma volume and CT signs of brain compression.

Conclusion. Computed tomography plays a decisive role in diagnosis, prognosis, and selection of surgical strategy in patients with bilateral multiple traumatic intracranial hematomas.