Concluded Case

Traumatic Brain Injury

New case 38 yr , M,H/ o of RTA.Riding bike when he went in a speed breaker, he ejected out from the seat and fell down to the ground on 9th at 6 pm.On exam drowsy , moving the left side spontaneously& paucity of rt sided movements..DTRS equal, extensor plantar rt side.Admitted under the neurosurgical ICU Opinion of ct & the management

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Concluded answer

Thanks for all answeres. CT brain shows * SAH along left frontotemporoparietal sulci,bilateral sylvian fissures,cistern of lamina terminalis,interpeduncular ,crural and ambient cisterns . * SDH along tentorium cerebelli and falx. * Diffuse cerebral edema with effacement of sulci and midline shift. Small SDH along lt frontotemporal convexity. Improved On conservative management .

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Traumatic brain injury,CT shows Multiple haemorrhagic contusions on left cerebral hemisphere with MLS and cerebral oedema. Intubation and hyperventilation,Routine investigations. Elevate head end to 30 degrees to reduce ICP Start anti edema measures,AEDs n repeat CT scan after 8hrs.If increased edema and MLS take for surgery.

Hemorrhagic contusion of left side of brain Cerebral edema Mid line shift mild Hypertonic saline Or mannitol Anti epileptic Anti fibrinolytic and supportive Intubation and ventilation to prevent aspiration later on tracheostomy Decompression craniectomy

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Thanks for all answers. Ct report:en closed. With conservative management pt improved & discharged

New case

Thanks for all answeres. CT brain shows * SAH along left frontotemporoparietal sulci,bilateral sylvian fissures,cistern of lamina terminalis,interpeduncular ,crural and ambient cisterns . * SDH along tentorium cerebelli and falx. * Diffuse cerebral edema with effacement of sulci and midline shift. Small SDH along lt frontotemporal convexity. Improved On conservative management .

Multiple hemorrhagic contusions seen in left F-T-P region Mild compression of Left lat ventricle seen Diffuse cerebral edema Suggest: Intubate ventilate-Target PCO2 30-35 AEDs Cerebral decongestants Supportive management Repeat CT after 12 hrs or before if worsens neurologically Neurosurgical opinion

Traumatic brain injury , CT shows multiple haemorrhagic contusions on left cerebral hemisphere with MLS and cerebral oedema.

38 YEARS OLD PT R T A MOTOR CYCLE ACCIDENT UNCONSCIOUS WITH SUBDURAL HEMATOMO OBSERVATION UNDER NEUROSURGOUN

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