Conservative treatment of intracranial hematomas and the dynamics of their resorption

: In 10 out of 63 patients with intracerebral haematomas treated conservatively the authors measured approximately the volume of haematomas by means of serial CT examinations during observation of their resorption. These were large and medium-size haematomas, from 20 to 70 ml in volume. The mean rate of resorption was from 0.7 to 1.0 ml daily. Gradual regression of mass effects was noted. All patients were on admission in a relatively good condition, conscious or only somnolent, with focal neurological signs. In some cases signs of increased intracranial pressure were present. Improvement of the general condition and neurological status was relatively rapid, even pronounced paresis and aphasia regressed in most cases. Two patients (3%) died of non-cerebral causes. It is believed that most intracerebral haematomas may be treated conservatively. The presence of mass effects, increased intracranial pressure or even a major neurological syndrome are not regarded as indications to operation if the state of consciousness is good and is not deteriorating. Even large and deeply situated haematomas may be resorbed without leaving a gross neurological deficit. A careful observation of the state of the patient, control CT investigations and the possibility of carrying out emergency operation in case of deterioration of the level of consciousness are indispensable for safe conservative treatment of these patients.