A 26yrs old male presented to casualty as a case of RTA leading to head injury.Initially patient was treated somewhere else and on ET tube we put him on venti support.primary survey and secondary survey done according to ATLS protocol. O/e - CNS - Deeply unconscious pupils - Dilated fixed GCS - E1 VTM1 BP - 100/70mmhg on inotropes Pr - 130/mt Poor prognosis explained to attendant.



The GCS is indicative of poor prognosis and no chance of survival. Diffuse axonal injury .Already respiratory and vasomotor centre in medulla are suppressed. Ventilatory support will not help .Better would be attendants take the patient home then spend on ventilator care

Multiple fracture left temporoparietal .SDH rt frontotemporal,thin SDH left,interhemispheric thin SDH ,brain edema with midline shift to left,diffuse punctate hemorrhages suggestive of axonal injury,Sulcal SAH. Major TBI,prognosis poor, supportive care

What abou afordibility if yes just give chance Younge age sad any external injury?? Severe cerebral oedema midline shift impending uncle herniation sdh sah conutercopu injury Ct fluid resuscitation ,check ABG cause of shock acidosis?? SE seum osmolality n urine osmolality, cbc RFT check for dolls eye reflex, EEG neuroSx ref start mannitol n tds 0.1mg/kg,antiepileptic ,decompresive b/l craniectomy will be better, plan trac after Sx, explain poor prognosis ,dvt pump lmwh od dvt after 48 hrs Sx ,if apnea test, dolls eye neg then counseling for organ donation , if You tell them at 1st they thought that u r pulling pt for profit best of luck

Poor prognosis GCS Low Diffuse axonal injury

Diffuse axonal injury, bilateral uncal herniation, durate hemorrhage severe and gross cerebral edema poor prognosis fatal battle..

DAI, Dural hge with gross edema uncal herniation and midline shift, please check brain stem function after adequate decompressive measures, if no brainstorm reflexes then probably no use wasting resources and prepare all for organ donation.

These patients are a potential candidate for organ donation. After appropriate evaluation and counselling this patient can give life to 6 other.

DAI grade 4

Diffuse Axonal injury , poor prognosis

Dai grade 3 with hypoxia brain injury explain relatives very poor prognosis

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Cerebral Edema
Bone Fracture
Brain Injury
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