CONTRACEPTUAL EPIDURAL HEMATOMA AFTER OPEN DECOMPRESSIVE CRANIOTOMY: CLINICAL CASE REPORT AND LITERATURE REVIEW

Xuân Phương Nguyễn , Mạnh Cường Trần , Thành Bắc Nguyễn

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Abstract

Male patient, 46 years old, presented to the emergency room of 103 Military Hospital on Monday due to a traffic accident. At the time of admission to the hospital, the patient was found to be in a coma with 7-8 points of Glassgow, had been intubated, right pupil was 2 mm, and 3 mm on the left, positive light reflex. Pulse 100 beats per minute, blood pressure was 160 over 90 mmHg without vasopressors. Computed tomography (CT) of the brain: acute left frontotemporal subdural hematoma, heterogeneous, 12 mm thick, left temporal contusion, subarachnoid hemorrhage and skull fracture on right temporal parietal and right middle basilar. The patient underwent decompressive craniotomy to remove subdural hematoma in the left hemisphere. 4 hours after surgery, the patient's clinical condition did not improve: Glassgow 6 points, right pupil postoperation  was 3 mm. Rapid pulse of 110 bpm and blood pressure was 170 over 100 mmHg. The patient had a CT scan of the brain: an image of epidural hematoma on the right appeared, with a volume of about 30 ml. The patient underwent surgery to remove the right epidural hematoma. Postoperative results were good. GOS 4 sequelae after surgery.

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References

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