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Pregnant Female with EDH

Ronald Gross Rgross at harthosp.org
Wed Apr 4 18:29:36 BST 2007


If she is not in labor, leave her alone and watch the EDH resolve.  If
she even thinks about going into labor - C-section.

>>> "Jago Miloguz" <japrak at gmail.com> 4/4/2007 11:57 AM >>>
what about situations where she deteriorates few days post accident and
that
induces labors which cause intracranial hypertension...
my question is how long to observe pregnant patient in 3rd trimestar?
and should she go to c-section to remove the risk of further ICH
stimuli?
apology for perhaps dumb questions,very much youngster in trauma field
Ante

2007/4/4, rwolfer at aol.com <rwolfer at aol.com>:
>
> 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 Surg
> 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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