Bedside catheter evacuation of predominantly isolated traumatic supratentorial hemorrhage

J Trauma. 2008 Nov;65(5):1194-9. doi: 10.1097/TA.0b013e318160dad5.


Background: Predominantly isolated intracerebral hemorrhage (ICH) is a rare complication after traumatic brain injury that tends to occur in patients with coagulation disorders.

Methods: We developed a minimally-invasive free-hand bedside catheter evacuation procedure using 3D-computerized tomography reconstruction imaging. Twelve patients were retrospectively analyzed.

Results: Average duration of the procedure was approximately 15 minutes. After catheter placement, urokinase-lysis ensured successful hemorrhage evacuation. Mean Glasgow coma scale at admission was 10 and mean hemorrhage diameter was 6.3 x 3.9 x 4.2 cm, or 55 mL. Mean hemorrhage reduction was 37 mL or 66% in a mean of 4 days. No catheter-related complications were observed. The 30-day and 6-month mortality rates were 16%. Mean extended Glasgow outcome scale at discharge was 4. After a mean of approximately 19 months, nine patients had a favorable, two an unfavorable outcome. One was lost to follow-up.

Conclusions: In comparison with previously published results, free-hand bedside catheter evacuation is a quick and easy-to-apply technique to evacuate predominantly isolated traumatic supratentorial hemorrhage that can be performed in any intensive care unit.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Injuries / complications*
  • Catheterization*
  • Cerebral Hemorrhage, Traumatic / etiology
  • Cerebral Hemorrhage, Traumatic / mortality
  • Cerebral Hemorrhage, Traumatic / therapy*
  • Female
  • Glasgow Coma Scale
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Retrospective Studies
  • Young Adult