A previously healthy 70-year-old woman presents to the emergency department with a 3-day history of fever, confusion, and lethargy. She is unable to cooperate with a full physical examination, but she has neck stiffness upon neck flexion. Her score on the Glasgow Coma Scale is 13 (eye, 4; verbal, 4; motor, 5). The findings from a chest radiograph and urinalysis are normal. You seek consent from...

A 95-year-old man with Alzheimer’s disease and diabetes mellitus was admitted because of a nonsyncopal fall resulting in a head injury while in the toilet. On physical examination, his Glasgow Coma Scale score was 14/15 (eye 4, verbal 4, motor 6) and no external injuries or focal neurological deficit was evident. Cardiovascular, respiratory, and abdominal examination findings were unremarkable....

We present a case of penetrating head injuries caused by blast fragmentation, along with other serious injuries (including to the arms, face and neck), where a good recovery was made despite an Injury Severity Score (ISS) of 75. We suggest that survival and outcome are reliant on several factors and cannot be predicted from ISS, velocity of penetrating injury or presenting Glasgow Coma Scale (G...

3. You attend to a young male patient who has sustained a head injury during an alleged assault. He is self-ventilating and haemodynamically stable, but is agitated with a reduced Glasgow coma score, and will require intubation prior to CT scan of his head. His mother is in the relatives’ room waiting for a progress update. The nurse helping you suggests you could get consent from his mother be...

Mild head trauma had been defined in patients with direct impact or deceleration effect admitted with a Glasgow Coma Scale score of 13-15. It is one of the most frequent causes of morbidity in emergency medicine. Although common, several controversies persist about its clinical management. In this paper, we describe the Brazilian guidelines for mild head trauma, based on a critical review of th...

The body core temperatures of 31 patients suffering from severe cerebral lesions were measured. Evidence for the existence or nonexistence of circadian rhythms in these patients was found to be associated with diagnosis (acute versus chronic lesions), with the level of consciousness, and with neurological findings (such as best motor response and pupillary reaction), but not with heart rate, co...

We present the CT and MR imaging findings in acute methanol intoxication in a 35-year-old man who was admitted to the emergency department with weakness, blurred vision, mild bilateral areactive mydriasis, and a progressive decrease in the level of consciousness. CT and MR imaging showed bilateral putaminal hemorrhagic necrosis and subcortical white matter lesions with peripheral contrast enhan...

Submit Manuscript | http://medcraveonline.com Abbreviations: MOF: Multiple Organ Failure; DCS: Damage Control Surgery; ISS: Injury Severity Score; GSC: Glasgow Coma Scale; PTT: Prothrombin Time; APTT: Activated Partial Thromboplastin Time; PTL: Platelets; PRBCS: Packed Red Blood Cells; FAST: Focused Abdominal Sonography For Trauma; CT: Computed Tomography; ROTEM: Rotational Thrombelastometry; F...

What other assessment can you make from his initial observations? Mr Carter is tachycardic, probably as part of a stress response to his acute illness, but is maintaining an adequate blood pressure. He is in respiratory distress but managing to raise his respiratory rate to maintain oxygen saturations at 92%. He is not compromised from a neurological point of view as he has a normal Glasgow Com...

The comatose patients with pontine hemorrhage of diameter greater than 2 cm have poor prognosis. A 59-year-old male was brought Glasgow coma scale (GCS) score E2M5V2. He mechanically ventilated. Magnetic resonance imaging (MRI) showed a hematoma, size 3 cm. improved. outcome (GOS) five. 57-year-old GCS E1M3V1. MRI scan hematoma 2.8 His GOS three at 6 months. This is report two survived cases la...