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Respiratory failure due to CNS trauma

Case contributed by Stefan Tigges
Diagnosis almost certain

Presentation

Respiratory failure.

Patient Data

Age: 30 years
Gender: Male

pCXR 3 days after admission.

x-ray

Endotracheal tube appropriately positioned, lungs clear.

Head CT at admission.

ct

Left frontal and temporal extra-axial hemorrhage with left frontal lobe intra-axial hemorrhage. Early midline shift. 

Head CT 2 days later.

ct

Increasing size extra-axial hemorrhage with worsening sub-falcine herniation and new lateral transtentorial herniation.

Head CT 3 days later.

ct

Interval left decompressive hemi-craniectomy with improvement in mass effect.

Case Discussion

This case shows that respiratory failure may occur for extrathoracic reasons, in this case, due to a severe brain injury.

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