Determination of bleeding time by hounsfield unit values in computed tomography scans of patients diagnosed with intracranial hemorrhage: Evaluation results of computed tomography scans of 666 patients

Abstract

Objective: Determining the bleeding time in intracranial hemorrhage patients is one of the most critical parameters in determining the surgical or medical treatment method. Since these are trauma patients, they are essential patients in forensic medicine. In patients where the bleeding time cannot be determined, HU value measurements in CT scans can provide quantitative data. In the radiological follow-up of the patients, only the follow-up of the bleeding volume may be misleading. Methods: CT scans of patients diagnosed with epidural, acute subdural, and intracerebral hematoma between 2016 and 2021 were evaluated. CT scans were examined in the first 2 h, 2–6 h, 6–12 h, 12–24 h, 24–36 h, 36–48 h, 48–72 h, and 72–96 h. Each time interval obtained the lowest, highest, and average HU values. HU value ranges were defined as the heterogeneity index within the same CT scan. Results: CT scans of 666 patients were evaluated. In patients with extra-axial hematoma, it was determined that the heterogeneity index increased over time. It was observed that the HU value decreased most slowly in the central part in intra-axial hemorrhages. Conclusions: HU value measurements in CT imaging can provide quantitative bleeding time and process data. Evaluating only the volumetric increase of the hematoma radiologically may cause erroneous results. HU value measurements are the most rational indicator of new bleeding. © 2022 Elsevier B.V.