RT Book, Section A1 Badjatia, Neeraj A2 Lee, Kiwon SR Print(0) ID 1101642549 T1 Neurotrauma T2 The NeuroICU Book YR 2012 FD 2012 PB McGraw-Hill Education PP New York, NY SN 9780071636353 LK neurology.mhmedical.com/content.aspx?aid=1101642549 RD 2024/10/03 AB Traumatic brain injury (TBI). A 42-year-old man presents to your intensive care unit (ICU) with acute brain trauma. He reportedly has fallen 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, makes incomprehensible sounds, 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 were reactive to light, and other brainstem reflexes were intact. 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, tidal volume of 480 mL, at a rate of 12 times per minute. Body temperature is 37.5°C. A computed tomographic image of the brain without contrast is obtained (Figure 4-1).