Extradural hematoma

Discussion:

This was an interesting case of traumatic right sided extradural hematoma, presenting to a regional hospital. 

The patient was intubated immediately after CT after a drop in conscious state and associated right sided blown pupil (3rd cranial nerve impingement), with aggressive medical management of his ICP, and transferred by road to a tertiary hospital with neurosurgical capabilities. Given the swift deterioration, and prolonged time of road transport, a decision was made by the tertiary trauma and neurosurgical team to meet the ambulance transport en route and perform a pre-hospital burr hole in the back of the ambulance. 

The patient was then transferred to definitive care at the tertiary hospital for decompressive craniotomy. 

He went on to make a full neurological recovery. 

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