Concluded Case

Acute Rt Frontotemporo- parietal SDH with subfalcine & uncal herniati

New case 70 yr,M, Alleged RTA 9th june at 7.30 PM,Pedestrian vs Two wheeler,fell down immediatltly and became unconcious.Arrived ER At 9.20 pm. Known case of seizure with old stroke on Ecosprin. ON Exam BP 130/ 70 mmhg .HR64/ mt .E1 M1Vt Pupils4mm Lt ,2 mm rt nonreacting .Intubated and mechanically ventilated at ER due to low GCS Planned for emergency surgery after discussing with relatives.

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Concluded answer
Thanks for all answeres. * Acte SDH Rt frontotemporoparietal with significant mass effect,midline shift with subfalcine & uncal herniation to left. * Diffuse brain edema Rt > Lt. * SAH along the Lt parieto temporal sulci & Rt sylvian fissure. * Two tiny hemorrhagic contusion anteromedial temporal lobe. * Pneucephalus ( small pockets) in Lt temporal Rt frontal Rt sylvian fissure. * Lt maxillary & shenoiidal hemosinus . * Oblique undisplaced # Rt parietal bone.
All Answers
Thanks for all answeres. * Acte SDH Rt frontotemporoparietal with significant mass effect,midline shift with subfalcine & uncal herniation to left. * Diffuse brain edema Rt > Lt. * SAH along the Lt parieto temporal sulci & Rt sylvian fissure. * Two tiny hemorrhagic contusion anteromedial temporal lobe. * Pneucephalus ( small pockets) in Lt temporal Rt frontal Rt sylvian fissure. * Lt maxillary & shenoiidal hemosinus . * Oblique undisplaced # Rt parietal bone.
Large SDH with mid line shift ...Need urgent decompressive surgery..Ventilator support..and NICU care ...
Valuable opinion
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Gcs is too bad, 70 years age... my approach will be DNR

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