Acute Subdural Hematoma

Acute Subdural Hematoma

A 60-year-old right-handed female developed intense headaches of increasing intensity, nausea, and emesis after falling stairs at home.. Computed Tomography (CT) of head performed one hour after the injury showed left sided large acute ASDH with significant midline shift. Her pulse was 82 per minute with regular rhythm, blood pressure was 190/60, respiratory rate was 24 per minute and oxygen saturation was 93% at 1 liter oxygen. The patient was Unconscious (E1V1M1) at the time of first admission. INR was 2.0. He had pupillary asymmetry (Left>Right). Right pupil was briskly reacting and right pupil was sluggishly reacting. He had history of atrial fibrillation and he was on warfarin therapy.

 

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