unusual case

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It is really hard to see the ct Ao injury which I think that is what you r trying to point out. In the event of a true (not a VOMIT) Ao injury with combine TBI, non operative management with control of patient delta P/delta T with breviblock is indicated. On the other hand special attention needs to be taken for good ICP/CPP readings in order to prevent secondary brain injury. Good judgment and close ICU care is a most.
Please send more cuts of the CT.
Always remember communication is of the essence among physicians in polytrauma patients.
Good case.
Juan
CharityOne
Sent via BlackBerry by AT&T

-----Original Message-----
From: Tchaka Shepherd <tshepherdmd at hotmail.com>

Date: Thu, 1 May 2008 10:09:29 
To:"Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
Subject: RE: unusual case



Can you send more images of the CTA?




----------------------------------------
> To: trauma-list at trauma.org
> From: nappio at aol.com
> Date: Thu, 1 May 2008 16:50:34 +0000
> Subject: Re: unusual case
> 
> CHI and c spine injury. What is unusual?
> Sent from my Verizon Wireless BlackBerry
> 
> -----Original Message-----
> From: "Michael Stein M.D." 
> 
> Date: Thu, 1 May 2008 19:37:42 
> To:"'Trauma & Critical Care mailing list'" 
> Subject: RE: unusual case
> 
> 
> Not enough cuts from the CTA but...
> If Neuro don't want him STAT in the OR, perform FORMAL Arch + 4 vessel
> Angiography and go on from there.
> Mickey
> 
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
> On Behalf Of daniel simon
> Sent: Thursday, May 01, 2008 6:29 PM
> To: trauma-list at trauma.org
> Subject: unusual case
> 
> 43 year old motorcycle crash victim , on scene intubation for GCS of 5. On
> admission intubated and ventilated, B.P 130/80 P 82 sat 100% , GCS 7 (T) .
> PE: skin lacerations and  central hematoma anterior neck - zone 1.
> Head CT - SAH, Frontal contusions,small Frontal SDH, many skull fractures.
> C-spine:  fracture of C1
> Chest XR and relevant cuts from the chest  CTA included.
> Abdominal CT normal
> What would you do now?
> 
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