strongly suggested as soon as possible if a decline of
2 points occurs in the GCS score, if the intracranial
pressure is greater than 20 mmHg, or if an abnormal
pupil reaction is detected, despite a thickness of hematoma
greater than 10 mm and midline shift less than 5
mm. Our clinical experience is similar to this report.
Patients who have a detected mass effect have to be
operated upon urgently.