TRAUMATIC INTRACEREBRAL HEMORRHAGE SURGERY VERSUS CONSERVATIVE MANAGEMENT: A RANDOMIZED CONTROLLED STUDY

Abstract

Backgroud: In India and other developing countries, traumatic brain injuries (TBIs) are a leading cause of morbidity, mortality, disability, and socioeconomic losses. In India, incidence is 56–430 per 1 lakh population. Major intracranial hematomas encountered are extradural hematoma, subdural hematoma, and traumatic intracranial hemorrhage (TICH) due to TBI.

Methods: This study is a prospective randomized control study conducted at the Department of Neurosurgery, NIMHANS, Bengaluru. Patients of traumatic intracerebral hematoma who are in clinical equipoise from January 2018 to June 2018 were enrolled in the study. The patients were enrolled to the study who got admitted to neurosurgery casualty. The details of the patients were collected including demography, clinical findings, and radiological findings which were noted. All the patients who were considered for this study underwent computed tomography brain to confirm the diagnosis, the size, and location of the hematoma.

Results: The general demographic data with clinical profile of patients are noted in tabular format. Out of 86 patients, 30 (34.48%) patients underwent early surgery, 47 (54.65%) patients were managed conservatively, and 9 (10.4%) patients were initially managed conservatively but eventually underwent surgery. Rest all findings have been noted in tabular format for well understanding in main manuscript.

Conclusion: Even though the outcomes of the early surgery group and the initially conserved group appear similar and statistically not significant, the mortality is higher in the initially conserved group and there exists an absolute difference of 11.5% between these two groups in terms of mortality, which may suggest that early surgery is beneficial as compared to initial conservative management in the management of patients with TICH.