Traumatic Intracerebral Haematoma

Dr S S Ahmed, Dr Shuvamay Chowdhury, Dr Saurav Chowdhury

Md Ahiyan, a 17 months old toddler was admitted in the Neurosurgery Department of United Hospital 5 hours after falling from a height of 8 feet. After the impact, for half an hour, he was unconscious. He vomited 3 times but there was no convulsion. Initially he was taken to a Pediatrician who advised CT scan of brain. The CT scan revealed Extradural Hemorrhage (EDH) & Intracranial Hemorrhage (ICH) with midline shifting. On admission the boy was pale, neurological examination revealed his GCS was 9/15 (E2V2M5), pupils were 3 mm and reacted well to light. There was cut injury on the tongue with abrasions on the forehead and scalp. Patient’s guardians were counseled about the boy’s pathology, treatment options and the possible outcomes, complications, risks and benefits of the surgical treatment. Craniotomy & evacuation of EDH, ICH with Subarachnoid Hemorrhage (SAH) was done by a neurosurgical team led by Dr Syed Sayed Ahmed. His post-op period was almost uneventful except for slight constipation and a single instance of vomiting. After 8 days post-op recovery, he was much better with a GCS score of 15/15. He was neurologically and haemodynamically stable, his stitches were removed and he was subsequently discharged. Follow up visits presented us with a healthy, playful boy with normal neurological functions.