[Course dynamics and early prognosis of traumatic intracranial hemorrhage. III. Intracerebral hematomas (author's transl)].

56 traumatic intracerebral haemorrhages were surgically treated within a period of 3 years. In most cases, they were dur to severe craniocerebral traumas, often (in 71,4% of the patients) combined with calvarial fractures. The average age was 44,7 years, and the sex distribution male : female = 4:1. The temporal and frontal regions were the preferential sites in approximately equal incidence. Depending sites in approximately equal incidence. Depending upon the rapidity of the clinical course, acute haematomas are different from the sub-acute ones (12-hours limit); both groups differ from each other especially with regard to the prognosis involved. Disturbances of consciousness were most prominent in the clinical patterns: they were either primary and consistent (41.1%) or secondary and continually increasing (53,6%); a free interval was only rarely observed. The findings obtained on angiography if the carotid artery are not haematoma-specific. Proof of the existence of a haematoma is most reliably established via computed tomography, which is also a safe method to identify severe accompanying damage and posttraumatic cerebral edemas. The indications for surgery can be restricted by means of computed tomography to major haemorrhages with space-occupying growths and clinical signs of cerebral pressure, as well as in patients where the clinical pattern deteriorates during conservative treatment. In all other cases, it is advisable to adopt a cautious conservative attitude coupled with CT controls. Early prognosis (mortality 62,5%) depended on the severity of the primary traumatic cerebral damage, the extent of disturbance of consciousness, rapidity of the clinical course localisation of haemorrhage, and age of the patient.