Wellington Case Report. LEFT CHRONIC SUBDURAL HEMATOMA


 


 

 

DISCHARGE SUMMARY

A.B, 46 YEARS, MALE, 

 

Diagnosis: LEFT CHRONIC SUBDURAL HEMATOMA

Operation Performed- LEFT FRONTAL AND PARIETAL BURRHOLE CRANIOTOMY FOR EVACUATION OF CHRONIC SUBDURAL HEMATOMA.

Date of operation- 30th JAN 2023

Surgeon: Dr Charles Ugwuanyi.

Back ground Presenting Information:

The above named patient presented on account of referral from a peripheral center with symptoms of recurrent headache of 2 weeks duration and vomiting of 3 days duration.

He was in his usual state of health until about 2 weeks ago when he started having headaches. Initially left sided but later became generalized, increasing in intensity in the last 4 days with a VAS score of 9/10. There is associated vomiting non projectile, about 3 episodes, non bloody, containing recently digested meals. No history of blurry of vision, seizures, no weakness of any side of the body, no loss of consciousness, no history of facial deviation. There is no history dizziness, neck pain, no neck stiffness, and photophobia. He is a known hypertensive on amlodipine and telmisartan.

Neurology examination findings -His pupils are 3mm bilaterally reactive to light. GCS-15/15 E-4, M-6, V-5, Normal tone, power and reflexes in all limbs.

Based on the above findings, the above diagnosis was made and disscussed with patient. Consent was gotten.

Pre- op Management

·         FBC – WBC-6.5, PCV- 43%, PLT- 214.

·         E/U/Cr – Na-139, K- 4.19, Ur- 33, Cr- 0.98.

·         Clotting Profile – APPT- 24, PT-11.7, and INR-0.9.

·         Serology – Non reactive for HIV1&2, VDRL, HCV and HbsAg.

·         Brain CT- showed left chronic subdural hematoma

·         ECG – Normal findings.

·         DVT Prophylaxis – TED stockings applied.

·         Informed consent taken.

Imaging

·         Pre-operative  CT  brain showed left chronic subdural hematoma with a midline shift

 26 Jun, 2023

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