Ten cases of delayed posttraumatic hemorrhage were noted in a series of 216 patients. Initial computed tomographic (CT) scans performed in the first 6 hours after relatively mild injuries were normal. Six patients had initial mild concussions lasting less than 10 minutes and several had only mild confusion and/or headache. The symptom-free interval was 1 to 15 days, with an average of 5 days. The hematoma was located in the capsule-basal ganglia in 6 cases, the frontal lobe in 3, and the pons in 1. The clinical appearance of delayed posttraumatic hemorrhage included dysarthria, hemiparesis, aphasia, stiff neck, or drowsiness. Cerebral angiography demonstrated no underlying vascular disorders in any patient. A risk factor was a long-term daily alcohol intake in 2 patients. The underlying mechanism proposed for the basal ganglia hemorrhages was shear of the choroid anterior or lenticulostrate artery due to violent acceleration-deceleration and/or localized dysautoregulation of blood flow. Prognosis was good in these patients. Stroke. 1995; 26: 1531.
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