Multiple Trauma

Findings:
Depressed comminuted R frontoorbital fracture extending into frontal sinuses. IVH, SAH, contusions. L midbrain shear injury. Patent cisterns.

Discussion:
-trauma 3rd leading cause of death vs. stroke, leading cause of death in <44yo, CNS trauma 50% of trauma deaths
-CT predictors of outcome
         -effaced cisterns- mortality 77%
         -degree of shift has poor correlation
-classification of injury
      -primary= immediate: scalp injury, skull fx, extraaxial hemorrhage, neuronal injury
      -secondary= delayed: cerebral edema, herniation, hydrocephalus
-calvarial fractures
      -nondisplaced linear most common
      -depressed >0.5cm over motor/speech or >skull thickness-->operative intervention

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