Concluded Case

Acute left Subdural hemorrhage

Title Arrived ER with low GCS. Chief complaint. 48 yr,M, Referred firm another hospital with low GCS.He was found at home with restless state at 11 AM. .Evaluated at local hospital,received sedation and then transfered .The previous day he was alright and the morning he failed to get up as usual and the wife noted restlessness.No head ache / vomiting . Past medical history: ORIF done on 26 August 2022 ,both bones right leg for compartment syndome in another hospital. Known case of systemic hypertension10 yrs,DM type2 since 5 yrs on regular follow up and treatment.. Vitals: Received sedation at previous hospital. GCS-E1M1VT HR52/ mt. Afebrile.HR28/ mt. Intubated and ventilated at ER Physical exam: Pupils 2.5mm,poorly reacting.Unresponsive to verbal stimulation,partially due to sedation.Ocular movements not full. DTRs uniformly hypoactive with 0 plantars.No neck stiffness.. Investigation: At ER ABG,electrolyte panel,biochemistry, infective virology etc done. Urgent CT brain done. Diagnosis: keeping for discussion/ conclusion Management: Immediately after the CT brain ,Neurosurgeon was involved and transferred to NeurosurgeryICU for further management.and had undergone surgical procedure Questions. What abnormality in the CT brain? What is the duagnosis?. What was the surgical procedure ?

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30 people have viewed the case,but no one answered. CT findings. Acute subdural hemorrhage with hypodense area note in the left frontotemporoparietal region with maximum thickness of 25.2 mm in the left frontal region. Mass effect noted in the form of effacement of adjacent sulcal spaces occipital and temporal horns of left lateral ventricle and partial effacement of body of left lateral ventricle. Subfalcian herniation to Rt. Midline shift 14.7 mm to rt. Management: Pt had undergone lt FTP decompression craniectomy and evacuation of hematoma . prognosis: Became better.Discharged home

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30 people have viewed the case,but no one answered. CT findings. Acute subdural hemorrhage with hypodense area note in the left frontotemporoparietal region with maximum thickness of 25.2 mm in the left frontal region. Mass effect noted in the form of effacement of adjacent sulcal spaces occipital and temporal horns of left lateral ventricle and partial effacement of body of left lateral ventricle. Subfalcian herniation to Rt. Midline shift 14.7 mm to rt. Management: Pt had undergone lt FTP decompression craniectomy and evacuation of hematoma . prognosis: Became better.Discharged home

30 people have viewed the case,but no one answered. CT findings. Acute subdural hemorrhage with hypodense area note in the left frontotemporoparietal region with maximum thickness of 25.2 mm in the left frontal region. Mass effect noted in the form of effacement of adjacent sulcal spaces occipital and temporal horns of left lateral ventricle and partial effacement of body of left lateral ventricle. Subfalcian herniation to Rt. Midline shift 14.7 mm to rt. Management: Pt had undergone lt FTP decompression craniectomy and evacuation of hematoma . prognosis: Became better.Discharged home

30 people have viewed the case,but no one answered. CT findings. Acute subdural hemorrhage with hypodense area note in the left frontotemporoparietal region with maximum thickness of 25.2 mm in the left frontal region. Mass effect noted in the form of effacement of adjacent sulcal spaces occipital and temporal horns of left lateral ventricle and partial effacement of body of left lateral ventricle. Subfalcian herniation to Rt. Midline shift 14.7 mm to rt. Management: Pt had undergone lt FTP decompression craniectomy and evacuation of hematoma . prognosis: Became better.Discharged home

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