Concluded Case

SEVERE HEAD INJURY IN A 60YRS OLD MALE

74yrs/M reportedly fell in the morning was brought to the hospital in the evening,GCS 3 but moved lower limbs in response to pain after intubated him.Decided with Neurosurgeon and family only palliative care.

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Concluded answer

Bifrontal sdh with left temporal burst lobe with sdh ,if gcs E1V1M1 , AND PUPIL IS NOT REACTING , nothing to be done , on intubation lower limb movement may be present , what about the cough reflex , do all blood workup b, rule out coagulopathy ,continue ventilator support if motor movement increase and no coagulopathy , then can be plan for surgery, as given description ,prognosis explain

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Bifrontal sdh with left temporal burst lobe with sdh ,if gcs E1V1M1 , AND PUPIL IS NOT REACTING , nothing to be done , on intubation lower limb movement may be present , what about the cough reflex , do all blood workup b, rule out coagulopathy ,continue ventilator support if motor movement increase and no coagulopathy , then can be plan for surgery, as given description ,prognosis explain

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Is it unexplained fall? Drug history antiplatelets/ anticoagulation is important. Prognosis- Extremly poor. Ct shows rt cerebellar hemorrhagic contusion diffuse brain stem,diffuse SAH ,left parietotemporofrontal SDH,interhemispheric bleed,tentorial bilateral SDH.bifrontal SDH.diffuse sulcal SAH, transfalse and uncal herniation. Small old gliotic area rt temporal whitematter.

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Agree with manorama mam, Ct showing some old stroke and gliosis on rt hemisphere with severe SAH, seems out of proportion to nature of injury !!! Is there any other external injury ? Or any sign of assault? Sometime misleading information may provided !! Prognosis is poor, surgery only can give some hope..

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SIR, IT'S A CASE OF CVA..... THERE IS INTERACEREBRAL HAEMORRHAGE IN VENTRICLES, BRAIN STEM, TEMOPRAL LOBE ETC..... CHANCES OF SERVIVAL IS VERY LESS.... CONTINUE WITH SUPPORTIVE TREATMENT. YOURS SINCERELY. DR. RAJESH GOPAL.

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@Anand Kumar sir, @praveen yograj sir,@Bhupesh Kumar sir,@Yashesh Dalal sir,@Padam Chand sir,@Kapil Jain sir

GC too poor..nothing surgical advisable
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Prognosis are poor with a GCS score of 3 , ct suggests rt. Cerebellar hemorrhage along with contusion. Pallative care is the right call.

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Cva rt basal thalamic & rt parietal region of grey matter Any history of fall screening of cervical spine Opinion of neurosurgeon

Check for brain stem relflexes. If absent , go for apnea test. Prognosis is very poor. Good call for conservative management

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Bil subarachnoid, intracerebral hemorrhage noted. Looks poor prognosis.

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