Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Delayed Traumatic Intracerebral Hemorrhage in Patient with Hemoperitoneum Operation

혈복강 수술 환자에게서 발생한 지연성 외상성 뇌실질내 출혈

  • Kim, Sohyun (Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University) ;
  • Bae, Keumseok (Department of Trauma Center, Wonju Severance Christian Hospital, Yonsei University) ;
  • Pyen, Jinsu (Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University) ;
  • Kim, Jongyun (Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University) ;
  • Cho, Sungmin (Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University) ;
  • Noh, Hany (Department of General Surgery, Wonju Severance Christian Hospital, Yonsei University) ;
  • Whang, Kum (Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University) ;
  • Oh, Jiwoong (Department of Trauma Center, Wonju Severance Christian Hospital, Yonsei University)
  • 김소현 (연세대학교 원주세브란스 기독병원 신경외과학교실) ;
  • 배금석 (연세대학교 원주세브란스 기독병원 외상센터) ;
  • 변진수 (연세대학교 원주세브란스 기독병원 신경외과학교실) ;
  • 김종연 (연세대학교 원주세브란스 기독병원 신경외과학교실) ;
  • 조성민 (연세대학교 원주세브란스 기독병원 신경외과학교실) ;
  • 노하니 (연세대학교 원주세브란스 기독병원 외과학교실) ;
  • 황금 (연세대학교 원주세브란스 기독병원 신경외과학교실) ;
  • 오지웅 (연세대학교 원주세브란스 기독병원 외상센터)
  • Received : 2013.06.27
  • Accepted : 2013.09.02
  • Published : 2013.09.30
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Abstract

Delayed traumatic intracerebral hemorrhage (DT-ICH) is a rare event in head trauma patients. However, it develops unexpectedly and results in very severe brain damage. Thus, close monitoring of the neurologic status is needed for every trauma patient. Sometimes, however, neurologic monitoring cannot be done because of sedation, especially in cases of abdominal surgery. In this case report, we describe the case of a 37-yr-old, male patients who had hemoperitoneum because of spleen and renal injury. At the initial operation, massive bleeding was found, so gauze-packing surgery was done first. After the first operation, we sedated the patient for about two days, after which the packed gauze was removed, and the abdominal wound was closed. Immediately after the second operation, we found pupil dilation. Emergent CT was performed. The CT revealed DT-ICH with severe brain edema and midline shifting. However, the patient condition deteriorated progressively despite emergency operation, he expired 2 days after hematoma evacuation.

Keywords

References

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