Management of post traumatic intracerebral hemorrhage in adults conservative versus surgical

Traumatic intracerebral haemorrhage (TICH) is an extravasation of blood into brain parenchyma due to traumatic rupture of pial vessels. The currently used definition of TICH points out that it is a dynamic and expansive process inevitably leading to the deterioration of the neurological state. These dynamic processes are most pronounced in neurons, glial tissue and blood vessels. Traumatic brain injury is an insult to the brain resulting from an external mechanical force, possibly leading to permanent or temporary impairments of cognitive, physical, and psychosocial functions with an associated diminished or altered state of consciousness. Traumatic brain injuries are classified into primary and secondary injuries. Primary injury occurs as an immediate result of the trauma itself. Secondary injury occurs later as a result of the primary injury. Traumatic parenchymal mass lesions are common sequelae of traumatic brain injury. The prevalence of head trauma patients who develop ICH as a major CT finding ranges from 8% to 25% of all traumatic brain injury (TBI) and 13 to 35% of severe TBI. TICH is commoner than both the other types of mass haematomas put together (EDH and SDH) and accounts for 55 % of all traumatic intracranial haematomas. The median age of patients with TICH was lower than the median age of patients with SICH (51 years compared with 65 years, respectively), but it was much higher than the median age of the entire head-injury group (21 years). Ninety one percent of traumatic ICH were lobar and 75% of them were