RT Book, Section A1 Chang, Wan-Tsu W. A1 Badjatia, Neeraj A2 Lee, Kiwon SR Print(0) ID 1143954229 T1 Neurotrauma T2 The NeuroICU Book, 2e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071841443 LK neurology.mhmedical.com/content.aspx?aid=1143954229 RD 2024/03/28 AB Traumatic brain injury. A 42-year-old man presents to your intensive care unit (ICU) with acute brain trauma. He reportedly fell from a ladder at home while trying to fix the roof. There has been a loss of consciousness immediately after the fall, and he remains in obtunded mental status. In the emergency department (ED), his eyes open to painful stimulation, and he makes incomprehensible sounds and localizes to pain on the left side but is paretic on the right side (Glasgow Coma Scale [GCS] of 9: eye 2, verbal 2, motor 5). Pupils are reactive to light, and other brainstem reflexes are intact. The patient was intubated with an endotracheal tube. Initial vital signs: heart rate, 130 bpm; blood pressure, 160/90 mm Hg; oxygen saturation, 100% on assist control–volume control mechanical ventilation with FIO2 of 0.4; and tidal volume of 480 mL, at a rate of 12 times per minute. Body temperature is 37.5°C. A computed tomographic (CT) image of the brain without contrast is obtained (Figure 4-1).