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19 "Hemorrhage"
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Original Article
Resuscitative endovascular balloon occlusion of the aorta (REBOA) as a potential facilitator of definitive fascial closure in the open abdomen: a retrospective study in massive traumatic hemorrhage
Yoonjung Heo, Dong Hun Kim
J Trauma Inj. 2026;39(2):151-159.   Published online June 30, 2026
DOI: https://doi.org/10.20408/jti.2025.0310
  • 1,138 View
  • 18 Download
AbstractAbstract PDF
Purpose
Resuscitative endovascular balloon occlusion of the aorta (REBOA) effectively reduces uncontrollable torso hemorrhage in trauma. An open abdomen (OA) with temporary abdominal closure commonly follows damage control surgery in such cases. Early definitive fascial closure (DFC) is crucial to prevent complications such as enteric fistula, peritoneal abscess, or chronic ventral hernia. This study aimed to evaluate the effect of REBOA on DFC after massive traumatic hemorrhage.
Methods
This retrospective study analyzed 839 patients requiring massive transfusion at a level I trauma center between 2015 and 2022. Subgroup analyses were conducted among patients who underwent OA and DFC. Primary outcomes were DFC achievement and timing (≤48 hours vs. >48 hours). Secondary outcomes included various clinical outcomes.
Results
Of 229 patients meeting inclusion criteria, 76 (33.2%) required OA management, of whom 33 (43.4%) achieved DFC. The OA+ group demonstrated more severe injury (median Injury Severity Score, 34.0 vs. 22.0; P<0.001) and higher REBOA utilization (47.4% vs. 15.0%, P<0.001). Multivariate analysis showed that bowel perforation (adjusted odds ratio [OR], 6.75; 95% confidence interval [CI], 1.56–29.23; P=0.011) and Sequential Organ Failure Assessment (SOFA) score (adjusted OR, 0.58; 95% CI, 0.43–0.79; P<0.001) were independently associated with DFC achievement; REBOA use was not. Among patients achieving DFC, univariate analysis identified OA indication (OR, 0.11), number of laparotomies (OR, 0.16), and crystalloid volume (OR, 1.00) as factors associated with early closure (≤48 hours), though none remained significant in multivariate analysis.
Conclusions
Zone I REBOA did not significantly influence the achievement or timing of DFC following OA in trauma patients with massive hemorrhage. The deteriorating condition in REBOA recipients and the limited sample size may have affected these findings. Nevertheless, several clinical indicators were associated with DFC, suggesting potential utility in trauma care decisions.
Summary
Case Reports
Subclavian artery injury following clavicle fracture successfully treated with an urgent conversion to endovascular method: a case report
Jiwon Kim, Jonghwan Moon
J Trauma Inj. 2025;38(4):394-398.   Published online December 31, 2025
DOI: https://doi.org/10.20408/jti.2025.0168
  • 3,683 View
  • 50 Download
AbstractAbstract PDF
Subclavian artery injury is a rare complication of clavicular fracture. This condition most often results from penetrating trauma but may also occur after blunt injury, when bone fragments cause rupture, pseudoaneurysm, dissection, or arterial thrombosis. Subclavian artery injury associated with clavicular fracture occurs in less than 1% of cases and may lead to life-threatening hemorrhage or limb ischemia. We report a case of subclavian artery injury secondary to a clavicular fracture that was successfully managed with endovascular intervention. A 48-year-old man presented to the emergency department after a downhill bicycle crash with a right midshaft clavicle fracture and was scheduled for open reduction and internal fixation (ORIF) 11 days later. Intraoperatively, rupture of a subclavian artery pseudoaneurysm caused massive hemorrhage. Surgical dissection was complicated by severe perivascular inflammation and a high risk of iatrogenic subclavian vein injury. Immediate conversion to an endovascular approach allowed successful hemostasis through femoral artery access and covered stent deployment, after which ORIF was completed. The patient recovered without neurovascular complications and was discharged on postoperative day 5. At 12 weeks, he achieved full shoulder range of motion, and 2-year follow-up angiography showed no stent-related complications. This case underscores the effectiveness of emergent endovascular intervention for ruptured traumatic subclavian pseudoaneurysm when inflammation and risk of iatrogenic injury preclude safe open dissection. A hybrid or rescue endovascular strategy should be considered for similar complex trauma cases.
Summary
Spontaneous resolution of papilledema and multilayered hemorrhages in Terson syndrome associated with subarachnoid hemorrhage: a case report
Shreyas Temkar, Hemanth Ramachandar, Astha Gupta, Amit Kumar Deb
J Trauma Inj. 2025;38(3):290-293.   Published online June 25, 2025
DOI: https://doi.org/10.20408/jti.2024.0097
  • 2,397 View
  • 24 Download
AbstractAbstract PDF
Terson syndrome (TS) is a condition characterized by the association of intraocular hemorrhages with an underlying intracranial bleed. Although it is widely postulated that the condition arises from raised intracranial pressure, the occurrence of papilledema is rarely reported in TS. We present a case involving a 35 year old male patient who developed TS following a head injury. Papilledema was incidentally detected and managed with measures aimed at reducing intracranial pressure. The patient subsequently experienced spontaneous resolution of both the cerebral and ocular hemorrhages, as well as resolution of the papilledema. A dilated fundus examination is strongly recommended for any patient presenting with intracranial hemorrhage (especially subarachnoid hemorrhage) to identify intraocular hemorrhages and papilledema.
Summary
Liver laceration as a post-cardiopulmonary resuscitation complication in a person with breast implants: a case report
Min-Jeong Cho
J Trauma Inj. 2024;37(4):300-303.   Published online December 16, 2024
DOI: https://doi.org/10.20408/jti.2024.0077
  • 7,484 View
  • 113 Download
  • 2 Web of Science
  • 2 Citations
AbstractAbstract PDF
Cardiac compression is the most crucial component of successful cardiopulmonary resuscitation (CPR). However, CPR procedure poses a risk of complications, even when CPR providers perform cardiac compressions as recommended. Reports indicate that solid organ injuries, including liver injuries, occur with an incidence of about 0.6% to 3%. In this particular case, a 25-year-old woman was found hanged in her apartment. She was transported to a nearby hospital where CPR was administered for approximately 30 minutes until she was resuscitated. Subsequently, an abdomen-pelvis computed tomography scan revealed a liver injury. The location of the liver injury, between the sternum and spine, suggested it was a compression injury caused by CPR. There was no evidence of extravasation or active bleeding; thus, conservative management was chosen for the liver injury. By hospital day 4, the patient's pupil reflex had completely disappeared. Electroencephalography showed generalized attenuation, indicating severe global brain damage. Liver injury is a relatively rare post-CPR complication, with an incidence of 0.6% according to a retrospective analysis of a cardiac arrest registry. The liver is partially situated between the sternum and spine. The end of the sternum is shaped like an inverted triangle, resembling a sword. Therefore, if the CPR provider's hands are placed too low or excessive pressure is applied, the sternum can injure the left liver. Blood loss from liver injuries could potentially hinder the successful resuscitation of patients. In this case, had there been no blood loss from the liver injury, the patient might have maintained better cerebral perfusion and function.
Summary

Citations

Citations to this article as recorded by  
  • Injury Patterns in Resuscitated Non-Traumatic Cardiac Arrest Patients—A Comparative CT Analysis Between Automated Chest Compression Devices
    Simon Viniol, Lennart Scholand, Alexander König, Susanne Betz, Michael Scheschenja
    Diagnostics.2026; 16(8): 1179.     CrossRef
  • Liver injury after chest compressions: CT findings and diagnostic pitfalls
    Yuki Tanaka, Shuji Kariya, Miyuki Nakatani, Yasuyuki Ono, Takuji Maruyama, Kanji Sugiura, Noboru Tanigawa
    Clinical Imaging.2026; 139: 110933.     CrossRef
Exercise-induced traumatic muscle injuries with active bleeding successfully treated by embolization: three case reports
Yoonjung Heo, Hye Lim Kang, Dong Hun Kim
J Trauma Inj. 2022;35(3):219-222.   Published online September 28, 2022
DOI: https://doi.org/10.20408/jti.2022.0028
  • 8,126 View
  • 77 Download
  • 1 Web of Science
  • 1 Citations
AbstractAbstract PDF
Muscle injuries caused by indirect trauma during exercise are common. Most of these injuries can be managed conservatively; however, further treatment is required in extreme cases. Although transcatheter arterial embolization is a possible treatment modality, its role in traumatic muscle injuries remains unclear. In this case series, we present three cases of exercise-induced muscle hemorrhage treated by transcatheter arterial embolization with successful outcomes. The damaged muscles were the rectus abdominis, adductor longus, and iliopsoas, and the vascular injuries were accessed via the femoral artery during the procedures.
Summary

Citations

Citations to this article as recorded by  
  • Thermal and Magnetic Dual-Responsive Catheter-Assisted Shape Memory Microrobots for Multistage Vascular Embolization
    Qianbi Peng, Shu Wang, Jianguo Han, Chenyang Huang, Hengyuan Yu, Dong Li, Ming Qiu, Si Cheng, Chong Wu, Mingxue Cai, Shixiong Fu, Binghan Chen, Xinyu Wu, Shiwei Du, Tiantian Xu
    Research.2024;[Epub]     CrossRef
Severe Airway Obstruction due to Massive Retropharyngeal Hematoma in a Warfarin-Taking Patient with a Normal International Normalized Ratio
Hyun Young Cho, Hyung Il Kim
J Trauma Inj. 2021;34(1):57-60.   Published online January 14, 2021
DOI: https://doi.org/10.20408/jti.2020.0028
  • 6,425 View
  • 104 Download
AbstractAbstract PDF

Warfarin is used as part of the treatment of various diseases, and laboratory monitoring of its effects is required. Airway hematoma secondary to warfarin is rare, but can be fatal because of potential airway obstruction. Rapid definitive airway establishment is crucial if airway obstruction is suspected. This complication is more likely to occur in those with elevated coagulation laboratory values. However, we experienced a patient in whom a massive retropharyngeal hematoma caused airway obstruction after a non-severe motor vehicle collision. The patient had been taking warfarin, and had coagulation parameter values within the normal ranges. A major fracture or hemorrhage was not anticipated. Upon examination, a massive retropharyngeal hematoma was noted. Orotracheal intubation failed due to an airway obstruction. Emergency tracheostomy and an operation for hematoma removal were performed. Physicians must always consider the possibility of airway hematoma in warfarin-taking patients with normal coagulation values regardless of the severity of mechanism of injury

Summary
Hidden Hematologic Disease in Trauma Patients: A Report of Two Cases
Sung Woo Jang, Pil Young Jung
J Trauma Inj. 2020;33(2):112-118.   Published online June 17, 2020
DOI: https://doi.org/10.20408/jti.2020.016
  • 8,920 View
  • 102 Download
AbstractAbstract PDF

In trauma patients, coagulopathy and abnormal increases or decreases in cell counts are frequently observed, and are associated with high mortality and morbidity in the acute phase of trauma. Because major trauma is often life-threatening, and hematologic abnormalities are multi-factorial and transient, major blood loss is usually suspected to be the primary cause of these abnormalities, and much time and cost may be spent attempting to identify a focus of hemorrhage that might or might not actually exist. Persistent abnormalities in the complete blood count, however, require clinical suspicion of other hematologic diseases to minimize improper transfusions and to improve outcomes, including mortality. Physicians at trauma centers should be familiar with the clinical characteristics of hematologic diseases and should consider these diseases in trauma patients. In this report, we present cases of two hematologic disorders found in trauma patients: autoimmune hemolytic anemia induced by systemic lupus erythematosus and myelodysplastic syndrome.

Summary
Original Articles
Immediate Post-laparotomy Hypotension in Patients with Severe Traumatic Hemoperitoneum
Gil Jae Lee, Min A Lee, Byungchul Yoo, Youngeun Park, Myung Jin Jang, Kang Kook Choi
J Trauma Inj. 2020;33(1):38-42.   Published online March 30, 2020
DOI: https://doi.org/10.20408/jti.2020.014
  • 11,447 View
  • 143 Download
AbstractAbstract PDF
Purpose

Immediate post-laparotomy hypotension (PLH) is a precipitous drop in blood pressure caused by a sudden release of abdominal tamponade after laparotomy in cases of severe hemoperitoneum. The effect of laparotomy on blood pressure in patients with significant hemoperitoneum is unknown.

Methods

In total, 163 patients underwent laparotomy for trauma from January 1, 2013 to December 31, 2015. Exclusion criteria included the following: negative laparotomy, only a hollow viscous injury, and hemoperitoneum <1,000 mL. After applying those criteria, 62 patients were enrolled in this retrospective review. PLH was defined as a decrease in the mean arterial pressure (MAP) ≥10 mmHg within 10 minutes after laparotomy.

Results

The mean estimated hemoperitoneum was 3,516 mL. The incidence of PLH was 23% (14 of 62 patients). The MAP did not show significant differences before and after laparotomy (5 minutes post-laparotomy, 67.5±16.5 vs. 68.3±18.8 mmHg; p=0.7; 10 minutes post-laparotomy, 67.5±16.5 vs. 70.4±18.8 mmHg; p=0.193). The overall in-hospital mortality was 24% (15 of 62 patients). Mortality was not significantly higher in the PLH group (two of 14 [14.3%] vs. 13 of 48 [27.1%]; p=0.33). No statistically significant between-group differences were observed in the intensive care unit and hospital stay.

Conclusions

PLH may be less frequent and less devastating than it is often considered. Surgical hemostasis during laparotomy is important. Laparotomy with adequate resuscitation may explain the equivalent outcomes in the two groups.

Summary
Comparison of the Surgical Approaches for Frontal Traumatic Intracerebral Hemorrhage
Eun Sung Park, Seong Keun Moon, Ki Seong Eom
J Trauma Inj. 2019;32(2):71-79.   Published online June 30, 2019
DOI: https://doi.org/10.20408/jti.2019.002
  • 11,012 View
  • 124 Download
  • 5 Citations
AbstractAbstract PDF
Purpose

Recent developments in minimally invasive techniques have the potential to reduce surgical morbidity, promote patient recovery, accelerate surgical procedures, and thus improve cost-effectiveness in case management. In this study, we compared the treatment efficacy and results of supraorbital keyhole approach (SOKA) with those of conventional unilateral frontal craniotomy (CUFC) for traumatic intracerebral hemorrhage (TICH) in the frontal lobe.

Methods

We analyzed the data of 38 patients who underwent CUFC (n=30) and SOKA (n=8) and retrospectively reviewed their medical records and radiological findings. Furthermore, we tried to identify the best surgical method for such lesions by including patients who underwent burr hole aspiration and drainage (BHAD) (n=9) under local anesthesia due to various circumstances.

Results

The difference in the initial Glasgow coma scale score, operative time, and length of hospitalization between the CUFC and SOKA were statistically significant. All radiological features between the two groups including associated skull fracture, amount of pre- and postoperative hematoma, percentage of complete hematoma removal, pre- and postoperative midline shifting of the hematoma, and development of postoperative delayed hematoma were not statistically significant. Our experience of 46 patients with TICH in the frontal lobe with any of the three different surgical methods including BHAD enabled us to obtain valuable findings.

Conclusions

Although it is difficult to insist that one particular approach is more useful than the other, we are confident that SOKA will have more advantages over CUFC in carefully selected patients with frontal TICH depending on the surgical experience of a neurosurgeon.

Summary

Citations

Citations to this article as recorded by  
  • Bilateral Traumatic Frontal Hematoma Evacuation Using the Supraorbital Keyhole Approach: A Case Report Elucidating Surgical Technique
    Alex Michel Daoud, Lorenna Filice, Jean Gonçalves De Oliveira, José Carlos E Veiga, João Luiz Vitorino Araujo
    Cureus.2025;[Epub]     CrossRef
  • A Study to Evaluate Prognostic Factors and Define a Critical Volume for Early Surgery in Patients with Bifrontal Brain Contusions
    Manoranjitha Kumari M, T.P. Jeyaselva Senthilkumar, Yamunadevi Ravi
    Indian Journal of Neurosurgery.2024; 13(01): 044.     CrossRef
  • Applications of supraorbital keyhole craniotomy in pediatric cranial trauma: illustrative series of two cases and systematic literature review
    Joshua J. Loya, Chenyi Yang, Zach Pennington, Nolan J. Brown, Ali I. Rae, Jesse L. Winer
    Child's Nervous System.2023; 39(12): 3531.     CrossRef
  • Supraorbital eyebrow approach: A single-center experience
    Blessing Ndlovu, Mohammed Ouwais Abdul Sattar, Mlamuli Mzamo Mkhaliphi, Keletso Leola, Morena Nthuse Mpanza, John Richard Ouma, Christos Profyris
    Surgical Neurology International.2022; 13: 566.     CrossRef
  • Re: Comparison of the Surgical Approaches for frontal Traumatic Intracerebral Hemorrhage
    Luis Rafael Moscote-Salazar, Ezequiel Garcia-Ballestas, Pradeep Chouksey, Amit Agrawal
    Journal of Trauma and Injury.2020; 33(1): 59.     CrossRef
Case Reports
Internal Iliac Artery Ligation with Pad Packing for Hemodynamic Unstable Open Comminuted Sacral Fracture
Sung Kyu Kim, Yun Chul Park, Young Goun Jo, Wu Seong Kang, Jung Chul Kim
J Trauma Inj. 2017;30(4):238-241.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.238
  • 7,315 View
  • 52 Download
  • 3 Citations
AbstractAbstract PDF

A 52-year-old man experienced blunt trauma upon falling from a height of 40 m while trying to repair the elevator. The patient’s systolic blood pressure and hemoglobin levels were 60 mmHg and 7.0 g/dL, respectively, upon admission. A large volume of bloody discharge was observed in the open wound of the perianal area and sacrum. A computed tomography scan revealed an open comminuted sacral fracture with multiple contrast blushes. He underwent emergency laparotomy. Both internal iliac artery ligations were performed to control bleeding from the pelvis. Protective sigmoid loop colostomy was performed because of massive injury to the anal sphincters and pelvis. Pad packing was performed for a sacral open wound and perineal wound at the prone position. After resuscitation of massive transfusion, he underwent the second operation 2 days after the first operation. The pad was removed and the perineal and sacral open wounds were closed. After the damage-control surgery, he recovered safely. In this case, the hemodynamically unstable, open comminuted sacral fracture was treated safely by internal iliac artery ligation with pad packing.

Summary

Citations

Citations to this article as recorded by  
  • Missed Wooden Perineum Foreign Body Leading to Extensive Necrotizing Soft Tissue Infection: A Case Report
    Uttam Chaulagain, Sushil Gyawali, Kailash Mani Pokhrel, Kapil Khanal, Bishal Gaurav, Rabi Khadka, Abhaya Acharya
    Clinical Case Reports.2026;[Epub]     CrossRef
  • Clinical Outcomes of Different Angioembolization Techniques and Materials for Hemodynamically Unstable Pelvic Fractures: An Overlap Weighted Study
    Hui Li, Guangbin Huang, Yunfeng Yi, Tao Ai, Yong Fu, Yong Luo, Anyong Yu, Gongliang Du, Xingwen Zhang, Eryue Qiu, Cai Lin, Junyu Jiang, Dingyuan Du, Mao Zhang
    World Journal of Surgery.2025; 49(11): 3269.     CrossRef
  • Penetrating sacral injury with a metallic pipe: a case report and literature review
    Mahnjeong Ha, Kyoung Hyup Nam, Jae Hun Kim, In Ho Han
    Journal of Trauma and Injury.2022; 35(2): 131.     CrossRef
Temporary Closure for Sternotomy in Patient with Massive Transfusion Might Be Lethal
Maru Kim, Joongsuck Kim, Sung Jeep Kim, Hang Joo Cho
J Trauma Inj. 2017;30(1):12-15.   Published online March 31, 2017
DOI: https://doi.org/10.20408/jti.2017.30.1.12
  • 3,445 View
  • 16 Download
AbstractAbstract PDF
A 58-year-old male visited our emergency room for multiple traumas from explosion. On initial evaluation, hemopneumoperitoneum with liver laceration (grade 4) and colon perforation was identified. Hemopericardium with cardiac tamponade was also identified. Shrapnel was detected in the right ventricle. Damage control surgery was planned due to condition of hypotension. In operation room, control over bleeding was achieved after sternotomy, pericardiotomy, and laparotomy. Massive transfusion was done during operation. After gauze packing, operation was terminated with temporary closure (TC). Sanguineous fluid was drained profusely. Disseminated intravascular coagulopathy was confirmed through laboratory findings. No extravasation was discovered at hepatic angiogram. On re-operation, there was no active bleeding but oozing from sternotomy site was identified. Bone bleeding was impossible to control. Finally, reoperation was ended after gauze packing and TC all over again. The patient could survive for only a day after re-operation.
Summary
Original Article
Blush on Computed Tomography and Transcatheter Arterial Embolization in Pelvic Fracture
Jihun Gwak, Yong Cheol Yoon, Min A Lee, Byungchul Yu, Myung Jin Jang, Kang Kook Choi
J Trauma Inj. 2016;29(4):161-166.   Published online December 31, 2016
DOI: https://doi.org/10.20408/jti.2016.29.4.161
  • 4,231 View
  • 19 Download
AbstractAbstract PDF
PURPOSE
Bleeding is the primary cause of death after severe pelvic fracture. Transcatheter arterial embolization (TAE) is the mainstay of treatment for arterial bleeding. This study aimed to determine the frequency of bleeding by angiography of blush-positive pelvic fractures on computed tomography (CT) images. The bleeding arteries that were involved were investigated by pelvic angiography.
METHODS
This retrospective cohort study evaluated 83 pelvic fracture patients who were treated in the intensive care unit of the author's trauma center between January 01, 2013 and April 30, 2015.
RESULTS
Overall mortality was 9 of 83 patients (10.8%). Blush was observed in 37 patients; blush-positive patients had significantly higher mortality (24.3%) than blush-negative patients (0%). Twenty-four of the 83 patients (28.9%) underwent pelvic angiography. Bleeding was showed in 22 of 24 patients in pelvic angiography. TAE was successfully performed in 21 (95.5%) of the bleeding 22 patients. Angiography was performed in 23 of 37 blush-positive patients, and arterial bleeding was identified in 21 (91.3%). A total 33 bleeding arteries were identified in 22 angiography-positive patients. The most frequent origin of bleeding was internal iliac artery (69.7%) followed by the external iliac artery (18.2%) and lumbar arteries (12.1%).
CONCLUSION
The vascular blush observed in CT scans indicates sites of ongoing bleeding in pelvic angiography. TAE is an excellent therapeutic option for arterial bleeding and has a high success rate with few complications.
Summary
Case Report
Pelvic Bone Fracture with Preperitoneal Hemorrhage
Joong Suck Kim, Young Hoon Sul, Seung Je Go, Jin Bong Ye, Sang Soon Park, Gwan Woo Ku, Yeong Cheol Kim
J Trauma Inj. 2015;28(4):272-275.   Published online December 31, 2015
DOI: https://doi.org/10.20408/jti.2015.28.4.272
  • 2,962 View
  • 11 Download
AbstractAbstract PDF
Pelvic bone fracture with unstable vital signs is a life-threatening condition demanding proper diagnosis and immediate treatment. Unlike long bones, the pelvic bone is a three dimensional structure with complex holes and grooves for vessels and nerves. Because of this complexity, a pelvic bone fracture can lead to complicated and serious bleeding. We report a case of a fifty-year-old male suffering from a pelvic bone fracture due to a fall. An imaging study showed fractures of both the superior and the inferior ramus of the pubic bone, with contrast extravasation underneath them, resulting in a large preperitoneal hematoma. He was sent for angiography, which revealed a hemorrhage from a branch of the left obturator artery. Embolization was done with a glue and lipiodol mixture. The patient recovered without complication, and was discharged at four weeks after admission.
Summary
Original Article
Assessment of the Clinical and the Radiological Prognostic Factors that Determine the Management of a Delayed, Traumatic, Intraparenchymal Hemorrhage (DTIPH)
Je Il Ryu, Choong Hyun Kim, Jae Min Kim, Jin Hwan Cheong
J Trauma Inj. 2015;28(4):223-231.   Published online December 31, 2015
DOI: https://doi.org/10.20408/jti.2015.28.4.223
  • 3,453 View
  • 12 Download
AbstractAbstract PDF
PURPOSE
Delayed, traumatic, intraparenchymal hemorrhage (DTIPH) is a well-known contributing factor to secondary brain damage that evokes severe brain edema and intracranial hypertension. Once it has occurred, it adversely affects the patient's outcome. The aim of this study was to evaluate the prognosis factors for DTIPH by comparing clinical, radiological and hematologic results between two groups of patients according to whether surgical treatment was given or not.
METHODS
The author investigated 26 patients who suffered DTIPH during the recent consecutive five-year period. The 26 patients were divided according to their having undergone either a decompressive craniectomy (n=20) or continuous conservative treatment (n=6). A retrospective investigation was done by reviewing their admission records and radiological findings.
RESULTS
This incidence of DTIPH was 6.6% among the total number of patients admitted with head injuries. The clinical outcome of DTIPH was favorable in 9 of the 26 patients (34.6%) whereas it was unfavorable in 17 patients (65.4%). The patients with coagulopathy had an unexceptionally high rate of mortality. Among the variables, whether the patient had undergone a decompressive craniectomy, the patient's preoperative clinical status, and the degree of midline shift had significant correlations with the ultimate outcome.
CONCLUSION
In patients with DTIPH, proper evaluation of preoperative clinical grading and radiological findings can hamper deleterious secondary events because it can lead to a swift and proper decompressive craniectomy to reduce the intracranial pressure. Surgical decompression should be carefully selected, paying attention to the patient's accompanying injury and hematology results, especially thrombocytopenia, in order to improve the patient's neurologic outcomes.
Summary
Case Report
A Fatal Intracerebral Hemorrhage Complicated by Compartment Syndrome of the Upper Arm
In Bo Han, Young Sun Chung, Dong Eun Shin, Ryoong Huh, Sang Sup Chung, Jung Yong Ahn
J Korean Soc Traumatol. 2006;19(2):178-182.
  • 2,172 View
  • 6 Download
AbstractAbstract PDF
Compartment syndrome has a wide spectrum from muscle pain to a life-threatening condition, such as acute renal failure and disseminated intravascular coagulation (DIC). Intracerebral hemorrhage (ICH) due to compartment syndrome has not been reported. We report a patient who presented with ICH leading to death. A 25-year-old female with no significant past history developed extensive compartment syndrome followed by rhabdomyolysis, acute renal failure, DIC, and ICH. Although the patient underwent a fasciotomy and hemodialysis and received aggressive resuscitation with massive transfusions of blood and intravenous fluids, she died. This case stresses the importance of early diagnosis and prompt treatment of compartment syndrome to prevent devastating complications.
Summary

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