@article{ref1,
title="Traumatic tentorial hematoma in two-wheeler riders: correlation with helmet use",
journal="Asian journal of neurosurgery",
year="2016",
author="Agrawal, Deepak and Dawar, Pankaj",
volume="11",
number="4",
pages="392-395",
abstract="BACKGROUND: Tentorial hematoma is frequently seen in traumatic brain injury (TBI) patients, especially in motorized two-wheeler riders following head injury. However its relevance and prognostic significance are not known. <br><br>OBJECTIVE: To evaluate patients of TBI with tentorial hematoma using a simple grading system and attempt to correlate this grading with factors like helmet use and neurological outcome. <br><br>MATERIALS AND METHODS: This prospective study over a 1-year period included patients with TBI who had tentorial hematoma in the initial plain head. Patients were divided into three grades based on the initial CT findings: Grade I: Isolated tentorial hematoma, grade II: tentorial hematoma with midline shift but open cisterns and grade III: Tentorial hematoma with effaced cisterns. Clinical and radiological records of patients including admission GCS and GOS at discharge were assessed in all cases. OBSERVATIONS: A total of 1786 patients of TBI were admitted during the study period. Of these, 106 (5.9%) patients had tentorial hematoma. 84.9% (n = 90) were male and 15.1% (n = 16) were female with the mean age being 36.5 years (range 2-66 years). The mean admission GCS was 13, 11 and 8 in patients with grade I, II and III tentorial hematoma respectively. 43.4% (n = 46) of the patients had grade I, 32.1% (n = 34) had grade II and 24.5% (n = 26) patients had grade III tentorial hematoma. Seventy-one patients (84.5%) were riding motorized two wheelers with 63 (89%) wearing helmets. The majority of the patients wearing helmets (58.8%) had grade I hematoma with 35% (n = 22) having grade II hematoma and only 6.3% (n = 4) having grade III hematoma. Overall, there were 20 deaths. 50% (n = 10) of the deaths were in patients with grade III hematoma and 40% (n = 8) of the deaths were in patients with grade II hematoma. There were two (10%) deaths in patients with grade I hematoma (both unrelated to head injury). The mean GOS at the time of discharge was 5, 4.1 and 2.2 in patients with grade I, II and III tentorial hematoma, respectively. <br><br>CONCLUSIONS: Tentorial hematomas are very common in two-wheeler riders with TBI and could be a marker for indirect forces such as rotational forces experienced while wearing helmets.<p /> <p>Language: en</p>",
language="en",
issn="1793-5482",
doi="10.4103/1793-5482.144182",
url="http://dx.doi.org/10.4103/1793-5482.144182"
}