List Archives

Wed Apr 4 14:24:06 BST 2007

Our neurosureons scan at 24 hours after admission and then if no change send them home 
Rebecca Wolfer, MD, FACS, FCCP
Associate Professor, Marshall University School of Medicine
Dept of Surgery
Director Thoracic Surgery
Director, Surgical Critical Care Cabell Huntington Hospital
Director, Trauma Cabell Huntington Hospital

-----Original Message-----
From: Rgross at harthosp.org
To: trauma-list at trauma.org
Sent: Wed, 4 Apr 2007 8:35 AM
Subject: Re: Pregnant Female with EDH

I have watched our neurosurgeons sit on small EDHs in patients without
lateralizing signs or alterations in their neurologic exam.  They are
admitted to the ICU and are scanned q12h.  While the need for a repeat
head CT is truly questionable in the absence of any change in neuro
exam, the fact is that these EDHs are not operated on if the patient
remains unchanged, and the EDH size remains likewise.
Ron

>>> navin goyal <drnavingoyal at yahoo.co.in> 4/3/2007 3:51 PM >>>
Dear Mail subscribers,

A young  and 35  wks preganat female had a fall from running train .
She attended our trauma centre two days after with complains  of
vomitting twice on that . Patient when attended our trauma centre was
comfortable except for the complains mentioned . GCS 15/15  P-72/min
BP-110/70 . No other complains .We got her CT Brain done . Which showed
small EDH in the posterior fossa and SAH in various other part of brain
. USG showed normal fetal well being with reactive  NST( Non stress
test).
I would like to know what should be done ? Whether EDH evacuation
should be done immediately?EDH evacuation should be done only if  the
patient has labor pain ? Whether Cesarean section should be done
immediately, alone or along with  EDH evacuation  ? Can we go on with
the conservative management.

Navin

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Pregnant Female with EDH