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HOME > J Trauma Inj > Volume 26(3); 2013 > Article
Delayed Traumatic Intracerebral Hemorrhage in Patient with Hemoperitoneum Operation
Sohyun Kim, Keumseok Bae, Jinsu Pyen, Jongyun Kim, Sungmin Cho, Hany Noh, Kum Whang, Jiwoong Oh
Journal of Trauma and Injury 2013;26(3):233-237
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1Department of Trauma Center, Wonju Severance Christian Hospital, Yonsei University, Korea.
2Department of Neurosurgery, Wonju Severance Christian Hospital, Yonsei University, Korea.
3Department of General Surgery, Wonju Severance Christian Hospital, Yonsei University, Korea.
Received: 27 June 2013   • Revised: 22 July 2013   • Accepted: 2 September 2013

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.

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