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 2024/04/24
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).