Muhamad Na'im B Ab Razak (jacknaim) is a fresh graduate Muslim Doctor from Universiti Sains Malaysia and waiting for the enrollment into the housemanship program. Ambitious in pursuing master program in emergency and traumatology medicine and loves to spent his free time joining humanitarian missions, writing and speaks as an amateur public speaker in motivation and comparative religion. [HOME]

OSCE pro III series 3


Answer


1)Abnormal findings
-Crescent shape hyper dense lesion at right fronto- parietal area
-Midline shift


2)Subdural hematoma of the right fronto temporal region.


3)Two indication for CT scan

-Post traumatic seizure
-GCS less than 13 during initial assessment or Drop in GCS during observation period (initially could be 15)
-Sign of basal skull fracture
-Suspected open or depressed skull fracture
-Sign of elevated ICP (> 1 projectile vomiting, papilledema, severe headache)
-Coagulopathy with any amnesia or Loss of consciousness since injury
-Any amnesia or loss of consciousness since injury if any (age > 65 years old, Coagulopathy or on warfarin, High velocity trauma)
-To confirm the diagnosis of stroke
-To rule out brain infection / space occupying lesion.


4)Treatment for above condition
-Position the patient 30 degree to reduce intra cranial pressure
-Give IV mannitol
-Emergency decompression surgery (open craniotomy with evacuation of the clot)