He was admitted previously on 23/5/2009 when he was alleged fell at home on the same day with admission GCS of E4V2M5. CT scan done showed right frontal ICH. He underwent craniotomy and evacuation of clots and discharged home with full GCS.
On arrival his GCS was E3 V2 M5 with pupils 3+/3+.
BP 146/76, HR 76 Afebrile Spo2 100% on air Lungs: clear CVS: DRNM P/a: soft, nontender Able to move all 4 limbs but unable to assess proper power CT brain
Mixed hyp & hyperdense lesion - SDH in left frontoparietal Thickness 4cm Local mass efeect on ipsolateral ventricle & contralateral MLS BC still patent Evidence of previous Rt frontoparietal craniectomy + encaphalomalacia Rt frontal lobe Impression: chronic Lt frontoparietal SDH He underwent left parietal burrhole and drainage on 27/6/09. Post-op he is remained ventilated and sedated.
Post-op CT scan on 28/6/09
Written Clinical Comments: post Burrhole drainage
Findings:
***No previous image in the PACS for comparison.
Evidence of right frontal craniectomy and left parietal craniotomy.
Left fronto-parietal SDH with fluid level with mass effect to
adjacent lateral ventricle.
Midline shift of 1.8cm to the right with subfalcine herniation.
Right frontal contusion with perifocal oedema.
Basal cisterns are effaced but not obliterated.
No hydrocephalus.
Visualised paranasal sinuses are clear.
Impression:
ICB with midline shift.
He underwent left parietal mini-craniotomy and subdural drainage on 29/6/2009
Written Clinical Comments: post Burrhole drainage
Findings:
***No previous image in the PACS for comparison.
Evidence of right frontal craniectomy and left parietal craniotomy.
Left fronto-parietal SDH with fluid level with mass effect to
adjacent lateral ventricle.
Midline shift of 1.8cm to the right with subfalcine herniation.
Right frontal contusion with perifocal oedema.
Basal cisterns are effaced but not obliterated.
No hydrocephalus.
Visualised paranasal sinuses are clear.
Impression:
ICB with midline shift.
On POD2, he was extubated. Pre-extubation GCS E4 VT M6.
3 comments:
what is sdh
@prasad581 sdh = subdural hematoma
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001732/
As vermin fostered a protection from the synthetic compounds utilized, so the ranchers expanded the utilization of them, until a top in the last part of the 1990's the point at which the utilization of insect poisons in a few Asian nations counted for around 40% of the creation expenses of cotton. Click here Online Dispensary Canada
Post a Comment