Pregnant Female with EDH

[Ben Reynolds]

Ditto.  In fact, some would argue that there is no
place for conservative management of traumatic
posterior fossa lesions given the thin line between an
intact neurologic exam and sudden death.  The area in
between those two extremes can be very grey.

Ben Reynolds, PA-C
Pittsburgh, PA
--- Ronald Gross <Rgross at harthosp.org> wrote:

> I agree completely.  
> >>> "Andrew J Bowman" <andrewj.bowman at gmail.com>
> 4/4/2007 3:44 PM >>>
> This is becoming more popular but posterior fossa
> space occupying
> lesions
> tend to be more worrisome as they can deteriorate
> quickly if bleeding
> resumes.
> 
> AJB
> 
> ----- Original Message ----- 
> From: "Ronald Gross" <Rgross at harthosp.org>
> To: <trauma-list at trauma.org>
> Sent: Wednesday, April 04, 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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