Bedside Catheter Evacuation of Predominantly Isolated Traumatic Supratentorial Hemorrhage

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.