Case report of severe head injury with bilateral intracranial hematomas: Multidisciplinary treatment results in good outcome

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  • OKUDA Kazunori
    Osaka Prefectural Nakakawachi Medical Center of Acute Medicine

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  • 両側頭蓋内血腫をきたしたが，集学的治療で良好な転帰が得られた重症頭部外傷の1例
  • 症例・事例報告 両側頭蓋内血腫をきたしたが,集学的治療で良好な転帰が得られた重症頭部外傷の1例
  • ショウレイ ・ ジレイ ホウコク リョウガワ ズガイ ナイ ケッシュ オ キタシタ ガ,シュウガクテキ チリョウ デ リョウコウ ナ テンキ ガ エラレタ ジュウショウ トウブ ガイショウ ノ 1レイ

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Abstract

<p>A female bicyclist in her 30s was struck by a car and immediately examined by a physician at that location, who found no airway, breathing, or circulation problems. Glasgow coma scale was 7 points, with left-sided incomplete paresis. Transportation to our medical center was done under respiratory ventilation with intubation. Whole body computed tomography (CT) indicated multiple traumas, including right contrecoup subdural hematoma. Burr-hole surgery was performed for elevated intracranial pressure (ICP) (43 mmHg). Follow-up CT findings revealed left coup epidural hematoma at the temporal bone fracture, thus left craniectomy and decompression procedures were done. No right contrecoup subdural hematoma expansion was revealed by CT, and intensive care was started 8 hours 40 minutes after admission. The respirator weaned, with extubation on day 12. Cranioplasty was performed on day 35 and hospital release was day 45. Left decompressive craniectomy for coup epidural hematoma and intensive care were effective for ICP control, with no need for a right craniectomy.</p>

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