Case scenarios on TBI

By Dr Tilahun (PGY3)
1. A 28 yrs old male pt was found uncommunicative in his bed
in the early morning. His family claims that he was okay
before he go to his bed expect that he was drunken.
V/S PR=112 RR= 8 Sao2= 76% ATT
GCS=5
no other pertinent physical finding
How do you approach?
2. A 60 yrs old male patient presented with worsening of
headache and lt side unilateral body weakness of 3 days
duration. He is also aphasic and incontinent to urine. The
family claims that he sustained fall down accident from a
horse 1 month back. V/S normal
GCS= 10A
power=0/5 on both lt upper and lower extremities

• do you approach this patient?

3. A 20 yrs old male patient presented to ED 1hr after sustaining
stick injury to his head after which he lost his conscious for 2
hrs. He also had bleeding from injury site and discharge
coming through his lt ear.
• how do you approach this patient?
4.1 hr after ED he developed one episode abnormal body
movement staying for 3 mins. What is your next
management?
Which of the following statements is true regarding
the incidence of seizures in traumatic brain injury ?

1. Antiepileptic medications decrease the incidence of

late seizures
2. Children < 2yo have a lower risk of seizures
3. Most early seizures occur in the first 24 hours
4. Seizures do not affect the outcome of traumatic brain
injury
5. All children with traumatic brain injury should be
treated with antiepileptic medications until 1 week
post-injury