Concluded Case

Extradural hematoma, astute decision making

presenting another large extradural hematoma managed without surgery, definite surgical case..f/8 years, stuporous but obeying, vomiting headache, normal pupils.. case selection and closed monitoring under neurosurgeon, AVOIDANCE OF MANNITOL very important.. have many such cases over last 23 years

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Concluded answer
" it's only when a surgeon learns what not to operate, he becomes a true surgeon"
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MANNITOL IS CONTRAINDICATED IN ALL CASES OF C V A AS IN C V A BLOOD BRAIN BARRIER IS BROKEN & MANNITOL GOES TO BRAIN FROM BLOOD & DRAWS FLUID FROM BLOOD TO BRAIN & CAUSE REBOUND CEREBRAL EDEMA IN HEAD INJURY BLOOD BRAIN BARRIER REMAINS INTACT & MANNITOL IS INDICARED TO REDUCE BRAIN EDEMA
In head injury also, blood brain barrier is broken..Mannitol will rebound with oedema...Don't use mannitol at non speciality level..We use with lot of understanding and reasoning
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Extradural haematoma. Large EHD managed with surgery and avoidance of mannitol is really a surprised me. Miracles do happen it proved beyond doubt by you and time. Thanks Dr for sharing.
Thanks Dr Ramesh Kumar Singh
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It was not known to me that Mannitol is offending to manage EDH. Thanks very much for posting
Thank you doctor
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In my opinion if pts GCS is below 13 , conservative trial is risky. Better to operate.
Thank you doctor
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Mannitol can be Avoid in epidural haematoma, first I knew it. Thanks Doctor
Thank you doctor
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Extra Dural haematoma Lt parital region Good information about Mannitol
Thank you doctor
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Mannitol may result in EDH expansion by shrinkage of brain substance??
Yes, also edh is due to arterial rupture mostly, mannitol seeps from leakage site and with hygroscopic action increase.
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Extradural hematoma lt parietal region Thanx for guidance sir
Thanx dr Ramesh Kumar Singh
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Doing surgery is simpler as compared to managing without doing surgery, it takes more courage and efforts to manage without surgery - and it is always in best interest of patients Well done sir
Thank you doctor
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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
Thank you doctor
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