Case of the day


52yrs/M Pedestrian vs Bike to ED in drowsy mentality.Biker was speeding through the pedestrian crossing.N/h/o LOC,H/o - Vomitting present,O/e - GCS -12/16,Pupils - B/l 4mm SRTL,Vitals unremarkable.INTERPRET CT BRAIN WITH MANAGEMENT PLAN Chief Complaints Headache, vomitting History No relevant medical history present Physical Examination Frontal and scalp laceration present,GCS -12/16,Pupils - B/l 4mm SRTL,Vitals unremarkable.



Left frontal depressed fracture with contusion and surrounding edema Right mandible and Zygomatic #. Management ICP lowering agents AEDs,Steroids may be useful for the surrounding edema aiding to decrease ICP. Craniotomy/Elevation of the fracture was done by Neurosurgeon.Patient discharged in Satisfactory condition.

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Valuable opinion

Fracture with extradural heamatoma more clear images for to say like mid line shift and appears to with subarachnoid hemorrhage in interhemisphric fissure

@Parveen Yograj sir,@Manorama Rajan mam,@Dr. Yashesh Dalal sir,@padam Chand sir,@Abhijit V sir kindly opine

Patient will require neurosurgery intervention for displaced frature. Do electrolytes and seizure prophylaxis plus mannitol will be required as per neurosurgeon opinion

This CT includes LT. Side depressed skull bone fracture with large SDH in left side with Midline shift to left side. If GCS is good according to you we have to consult Neurosurgeon & go for emergency craniotomy for removal of collection of blood Note prognosis is already explained & chances of monoplegia & hemiplegia will be maximum

Vertex edh is there, as GCS is 12 he needs to be operated ASAP. Steroids are absolutely contraindicated in trauma cases.

Lt half hemisphere haemorrhage Skull fracture Midline shift to left Lacunar infarct Opinion of neurosurgeon

Displaced fracture of skull Urgently need intervention for skull displacement to correct it See blood report See ecg See 2decho See Chest xray Control bp See for spo2 N treat accordingly

Multiple displaced fracture of skull, cruciate type Need NSX intervention

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