Pregnant Female with EDH

[RWolfer at aol.com]

In a message dated 4/4/2007 11:58:54 AM Eastern Daylight Time,  
japrak at gmail.com writes:

what  about situations where she deteriorates few days post accident and  that
induces labors which cause intracranial hypertension...
my question  is how long to observe pregnant patient in 3rd trimestar?
and should she go  to c-section to remove the risk of further ICH stimuli?
apology for perhaps  dumb questions,very much youngster in trauma field
Ante

2007/4/4,  rwolfer at aol.com <rwolfer at aol.com>:
>
> Our neurosureons scan  at 24 hours after admission and then if no change
> send them  home
> Rebecca Wolfer, MD, FACS, FCCP
> Associate Professor,  Marshall University School of Medicine
> Dept of Surg
> Director  Thoracic Surgery
> Director, Surgical Critical Care Cabell Huntington  Hospital
> Director, Trauma Cabell Huntington  Hospital
>
>
> -----Original Message-----
> From:  Rgross at harthosp.org
> To: trauma-list at trauma.org
> Sent: Wed, 4  Apr 2007 8:35 AM
> Subject: Re: Pregnant Female with  EDH
>
>
> I have watched our neurosurgeons sit on small EDHs  in patients without
> lateralizing signs or alterations in their  neurologic exam.  They are
> admitted to the ICU and are scanned  q12h.  While the need for a repeat
> head CT is truly questionable  in the absence of any change in neuro
> exam, the fact is that these  EDHs are not operated on if the patient
> remains unchanged, and the EDH  size remains likewise.
> Ron
>
> >>> navin goyal  <drnavingoyal at yahoo.co.in> 4/3/2007 3:51 PM >>>
> Dear  Mail subscribers,
>
> A young  and 35  wks preganat  female had a fall from running train .
> She attended our trauma centre  two days after with complains  of
> vomitting twice on that .  Patient when attended our trauma centre was
> comfortable except for the  complains mentioned . GCS 15/15  P-72/min
> BP-110/70 . No other  complains .We got her CT Brain done . Which showed
> small EDH in the  posterior fossa and SAH in various other part of brain
> . USG showed  normal fetal well being with reactive  NST( Non stress
>  test).
> I would like to know what should be done ? Whether EDH  evacuation
> should be done immediately?EDH evacuation should be done  only if  the
> patient has labor pain ? Whether Cesarean section  should be done
> immediately, alone or along with  EDH  evacuation  ? Can we go on with
> the conservative  management.
>
> Navin
>
>
>
>
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That is just what our neurosurgeons do. Iam not saying it is right, but  that 
is how they do it



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