unusual case

[Timothy Craig Hardcastle]

Daniel

Looks to me as a relative observer that the RCCA is cut off and there
may be an abnormality of the arch too. Suggest a formal angio BEFORE you
play with stents!

What is his neuro status now?

Tim
Dr Timothy C Hardcastle
M.B., Ch.B. (Stell); M. Med (Chir) (Stell); FCS (SA)
Principal Surgeon-Lecturer / Sub-specialist: Trauma and Critical Care
Deputy director: Trauma Unit and Trauma ICU
Inkosi Albert Luthuli Central Hospital / UKZN
800 Bellair Road
Mayville, Durban
 
Postal: PostNet Suite 27
Private Bag X05
Malvern, 4055
KwaZulu Natal
 
timothyhar at ialch.co.za 
 

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of daniel simon
Sent: 01 May 2008 17:29
To: trauma-list at trauma.org
Subject: unusual case

43 year old motorcycle crash victim , on scene intubation for GCS of 5.
On
admission intubated and ventilated, B.P 130/80 P 82 sat 100% , GCS 7 (T)
.
PE: skin lacerations and  central hematoma anterior neck - zone 1.
Head CT - SAH, Frontal contusions,small Frontal SDH, many skull
fractures.
C-spine:  fracture of C1
Chest XR and relevant cuts from the chest  CTA included.
Abdominal CT normal
What would you do now?