Traumatic intracranial mass lesions: how soon for evacuation?

The purpose of this paper is to identify, by simple clinical parameters, those patients who are at particular risk for traumatic intracranial hematomas following accidental injury and to review the effects of delays in treatment on death from head injury. The findings indicate that vehicle occupants 30 years of age or younger are significantly (p less than 0.001) more likely to suffer from a "diffuse" head injury and serious truncal injury than they are to suffer a traumatic intracranial mass lesion. Conversely, older patients (60 years of age or older) injured in falls are more likely to have operable intracranial mass lesions without significant injury to the torso (p less than 0.001). Recommendations concerning early diagnosis and treatment of accident victims are made from these data.