1 / 84

Patient Case Presentation

Patient Case Presentation. Neurosurgery Red Service Gabriel Zada, MD Sean McNatt, MD LAC-USC Medical Center May 3, 2006. Patient J.A. History of Present Illness: 22 month old female I Irritability, nausea/vomiting, decreased p.o. intake for 6 days prior to admission

norman-kemp
Download Presentation

Patient Case Presentation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Patient Case Presentation Neurosurgery Red Service Gabriel Zada, MD Sean McNatt, MD LAC-USC Medical Center May 3, 2006

  2. Patient J.A. • History of Present Illness: • 22 month old female I • Irritability, nausea/vomiting, decreased p.o. intake for 6 days prior to admission • Low grade fever per parents • Multiple visits to emergency room + clinics over last week, got intravenous fluids and parents told her illness was viral

  3. Patient J.A. • History of Present Illness (continued): • Presented again to Pediatrics ER with lethargy, altered mental status • Bradycardic to pulse of 70s, hypertensive • Intubated and sedated in ER for airway protection • No recent seizures, no sick contacts • Past Medical History: • Past medical and surgical history unremarkable • Term birth, uncomplicated • Normal developmental milestones

  4. Patient J.A. • Physical Exam: • Patient intubated, sedated • Somnolent but arousable • Regards examiner, not following commands • Pupils briskly reactive and equal • Extraocular movements intact • Tone normal • Moving all extremities with full power • Normocephalic, no external signs of trauma

  5. CT Imaging

  6. Initial Management • Patient admitted to Neurosurgical ICU • Right ventriculostomy placed • Initial ICPs in the 20s, normalized with drainage • CSF yellow, proteinaceous • High ventriculostomy output (150 cc/12 hours) • Patient transferred to CHLA for definitive management

  7. MRI Brain

More Related