Indexing Title: RROQUE’s Medical Anecdotal Report [04-8]

MAR Title: “Scanning One’s Life in the New Millennium”

Date of Medical Observation: November 6, 2004

Narration:

Head injury almost certainly has always held a special place in the human experience. It was apparent not until one depressing evening of B.D. a 44-year-old male who was cruising along Quirino Avenue and met his tragic fate.  

 Donned with a bloody-drenched white shirt in a faded denim shorts and down trodden worn out pair of rubber shoes, B.D., was rushed to the Emergency Room of the nearest hospital.

His consciousness was lethargic. He sustained multiple lacerations in the forehead. His left eye was literally shut, blinded by swelling—instantly discolored by the consequent trauma.

After initial survey, He had a Glasgow Coma Scale (GCS) of 7, hardly responding to any verbal stimulus. He had no other injuries, and most attention was focused on a possible traumatic brain injury. 

Initial radiographic imaging of the skull revealed intact cranial vault with concomitant Left periorbital swelling. With 6 hours of clinical observation and aggressive resuscitation, GCS score was in a status quo. B.D. had his first hand scanning experience of his life—his first ever cranial CT scan.

The advent of CT scan findings specifically identified with accurate detail the cause of B.D.’s GCS score. CT scan plates showed left frontal sinus fracture and small subdural hematoma on the left temporal lobe.

Insights (PHYSICAL, psychosocial, ethical) / (Discovery, Stimulus, REINFORCEMENT):

 Reinforcement:

 The ability to identify and localize hematomas and contusions quickly vastly expedited the first priority of the treatment of patients with neurotrauma—the identification and treatment of space occupying lesions (bleed, hematoma, hemorrhage). Initial and available imaging techniques coupled with diligent history and physical exam would still miss a subset of patients with significant findings, betraying an awareness of the clinical importance of traumatic brain injury.

This new millennium hopes to provide a more detailed understanding of brain injured patients. Our institution on the other hand could venture into relevant research as to: 1) identification of patients—candidates for CT scan, 2) sensitivity of imaging techniques (skull x ray and Ct scan) in relation to outcome of traumatic brain injured patients.

The measures of success for all these endeavors will be the physician’s ability to return patients to their normal life.