Progressive intracranial hemorrhage after acute head trauma is often observed on serial computerized tomography (CT) scans but its significance is uncertain. In this study, patients with acute head trauma were analyzed to determine the progressive hemorrhagic factor.

Between January 2004 and December 2004, 154 patients ware admitted to department of neurosurgery due to head trauma. Among 154 patients, 59 patients in whom two CT scans were obtained within 24 hours of trauma were analyzed retrospectively.

The diagnosis of progressive intracranial hemorrhage was determined by comparing the first and second CT scans. Progressive intracranial hemorrhage occurred in 45% of head-injured patients who underwent two CT scaning within 24 hours. Among 59 patients, progressive intracranial hemorrhage was found in 27 patients. Older age and male sex was associated with progressive hemorrhagic factor (p=0.025, p=0.035). A short time interval between trauma and the first CT scans was associated with progressive hemorrhagic factor (p=0.014). Initial Glasgow coma scale and skull fracture was not associated with progressive hemorrhagic factor (p=0.719, p=0.71).

Older age, Male sex, short interval from injury to first CT scans was associated with progressive intracranial hemorrhage. Patients with these hemorrhagic factors must be observed closely.