Bilateral SDH.
New case. 47 yr ,M ,Attended todays OPD with Diffuse intermittent head ache of 1 month . Each episode for 30 mts ,5 to 6 episodes in a day. Constricting type ,not associated with nausia / vomiting / vertigo / alteration in sensorium. RTA on 27 -8- 2020 when the two wheeler he was riding collided with another and sustained # nasal bone and # femur left side.Treated at local town ,CT brain was done with normal brain parenchyma. On exam vitals stable. BO 130/ 80 mmhg. Intact cranial nerves. No long tract signs.No neck stiffness.After seeing the CT brain ,he was transferred to the Neurosurgeon What abnormality in the CT brain.
Thanks Curofy and others who answered the case. Ct shows sub acute SDH left parieto temporofrontal with hyperdensity with the lesion,maximum thickness parietal convexity. Another SDH rt frontal and small SDH Rt parietal region. Left frontoparietal burrhole craniectomyand evacuation , rt frontal burrhole evacuation of SDH done under GA in one setting. pt is better l
Thanks Curofy and others who answered the case. Ct shows sub acute SDH left parieto temporofrontal with hyperdensity with the lesion,maximum thickness parietal convexity. Another SDH rt frontal and small SDH Rt parietal region. Left frontoparietal burrhole craniectomyand evacuation , rt frontal burrhole evacuation of SDH done under GA in one setting. pt is better l
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Chronic left SDH Surgical evacuation is tt of choice
An extensive traumatic acute on chronic sub- dural haematoma extending from the left fronto- temporo parietal and occipital region . As injury is 2 months old - the haematoma by this time liquefied as per the appearance on NCCT head and just needs simple burr hole craniotomy and evacuation of SDH
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