To analyze the risk factors of delayed intracranial hematoma after craniotomy.

Fifty-four patients with delayed intracranial hematoma after craniotomy in Department of Neurosurgery, Yanda Hospital Affiliated to Hebei Medical University from June 2015 to June 2020 were classified as a delayed hematoma group; At the same time, 54 patients without delayed hematoma after craniotomy were classified as no delayed hematoma group. According to the prognosis, 54 patients with delayed intracranial hematoma were divided into poor prognosis (19 cases) and good prognosis group (35 cases). The clinical data and risk factors of delayed intracranial hematoma were analyzed.

There were significant differences in Babinski positive, cerebral contusion, skull fracture, brain contusion, cerebral hernia, basilar cistern compression, operation time, diastolic blood pressure, GCS score, fibrinogen, fasting blood glucose, thrombin time (TT) and activated partial thromboplastin time between delayed hematoma group and non delayed hematoma group (P<0.05). Multivariate Logistic regression analysis confirmed that Babinski positive, skull fracture, operation time and TT were independent risk factors of delayed hematoma. In delayed intracranial hematoma, there were statistically significant differences between poor prognosis group and good prognosis group in pupil change, cerebral hernia, bone flap removal, midline deviation, hematoma volume, systolic blood pressure, GCS score, fasting blood glucose, delayed hematoma volume, postoperative platelet, postoperative basal cistern compression, and postoperative midline deviation (P<0.05). Multivariate binary Logistic regression analysis showed that flap removal, fasting blood glucose, postoperative basal cistern compression and postoperative midline deviation were independent risk factors for poor prognosis.

For patients with craniocerebral injury with independent risk factors, active treatment can prevent early intracranial hematoma after operation, which is beneficial to prognosis.