Presentation
High-speed motor vehicle collision. GCS 7.
Patient Data
Bilateral inferior frontal contusions, Small volume right frontal subarachnoid hemorrhage. Thin low-density extra-axial collection over the floor of the right anterior cranial fossa, suggesting small subdural hygroma. Small volume of pneumocephalus.
Depressed right frontal skull fracture with small volume of associated extra-axial hemorrhage. Displaced fracture through the anterior cranial fossa floor bilaterally with small bone fragments displaced intracranially on the right.
Linear bone fragment within the frontal sinuses, unclear donor site. Displaced fracture of right medial orbital wall. Minimally displaced fractures of the nasal bones and frontal processes of the maxilla bilaterally. Pterygoid plates are intact.
Case Discussion
The patient proceeded to OT for elevation of the depressed skull fracture and ICP monitor insertion.