30/06/2024
A 79-year-old man was present with head trauma in a traffic accident but still awake. 2 hours later, The patient arrived hospital with a comatose status, and then our doctor assessed ABCD. The decision intubation with mechanical ventilation immediately. After that, the Doctor requests more investigation.
* Chest x-ray:
- Bilateral para hilar alveolar opacities.
- Bilateral para-hilar peri-broncho vascular thickening
* Echocardiography:
- ETT is in favor of hypertensive heart disease at LVEF 65%.
- LV filling pressure is not high.
* Brain CT without injection:
- Subdural hematoma of different ages of the left cerebral hemisphere
- Minimal subarachnoid hemorrhage of the falx cerebri, tentorium, and bilateral frontotemporal-parietal cortical sulci.
- Diffuse cerebral edema.
- Engagement under Falcoriel Worm on the right. Central commitment.
- Hematic flooding in the lateral ventricles, predominantly left.
- Linear fracture of the right parietal bone.
- Fracture of the right petrous bone with the hematic filling of the opposite right mastoid cells.
What will you do more further management on that patient?