15yrs old male brought to ER in conscious state with alleged H/o sustaining head injury in RTA.H/o LOC and Vomitting present.upon arrival to ER patient fully conscious,oriented to time,place and person.All vitals parameters are stable,Hb - 7.9 DIAGNOSIS and MANAGEMENT?
A large right temporal extradural haematoma As patient is a stable, immediately shift to OT and burr hole craniotomy and evacuation of haematoma ad early as possible In such cases prognosis is extremely good and almost100 % if surgery done earliest
Left parietal EDH with depressed fracture. Elevation and fixation with removal of EDH done,patient stable.
CASE OF RTA Rt.temporal bone # traumatic Rt.EDH WITH AIR CELLS NEEDS URGENT EVACUATION OF EDH WITH ELEVATION OF # TEMPORAL BONE TO AVOID CORTICAL IRRITATION PRODUCING SEIZURE (FOR FEATURE) In EDH usually Pt.rapidily clinical deterioration occurring. to avoid that we have to do surgical intervention.
Large EDH wt mild SAH Bur hole surgery/ evacuation of hematoma Watch for GCS If GCS deteriotate dn Intubation n ventilation Antiepileptics mannitol Basic labs n echo
I saw the answers and most people are saying that it's right parietal depressed fracture with EDH. Yes it does require urgent surgery as post surgery the prognosis is very good and almost equal to hundred percent. One thing that Must be checked is the side of the lesion. I think CTscan is Flipped And it is not the right side but left sided lesion.
Rt.extradural hemorrhage.adv. evacuation
Rt parietal EDH with depressed # rt parietalNeeds urgent neurosurgical reference
Order 4 units blood and transfuse while preparing for surgery. Start surgery after 2 transfusions. Evacuate the edh and transfuse 2 more
Edh Trephine and remove
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