Background: Bilateral Intracranial hematoma is an uncommon sequela of closed head injury. Approach to this complicated problem is poorly defined. The present study tries to find out the incidence, and possible markers for the earlier detection of the problem.

Materials and Methods: In this descriptive study all head trauma patients undergoing surgical decompression from September 2006 to October 2008 in Kashan Beheshti Hospital, were included. Cases were studied for age, sex, cause of trauma, skull fracture, Glasgow Coma Scale Score, pre-operative CT findings, and the number of surgical procedures. Using SPSS software, the obtained data was analyzed through descriptive statistics, Chi Square and t-test.

Results: During a 24-month period, for 96 admitted patients with traumatic injuries, 121 surgical procedures were performed. Due to the hematomas, 73 (75.3%) and 23 (24.7%) cases had one and more than one surgical operation, respectively. In addition, the age range was between 6 months and 83 years in the former and 17 and 66 years in the latter with a mean of 40.7±24.1 and 33.7±15.9, respectively. Male/female ratio was 13.7/1 in unilateral cases and 22/ 1 in bilateral cases. In 31 (43%) out of 73 unilateral hematomas and 12 (52%) out of 23 bilateral cases various types of skull fractures were seen. While no significant difference was seen between the groups in terms of age, sex, cause of trauma, skull fracture, and GCSS , it was significant for subdural hematoma (P=0.004).

Conclusion: No specific marker could be found for early detection of bilateral intracranial hematoma. The high incidence of hematomas in our centre may be an incidental finding secondary to the high number of intracranial hematomas.