Traumatic Brain Injury and Neurocritical Care

A 23-year-old pillion rider without helmet fell off his bike when it hit the divider. He fell backwards with a laceration on occipital region of the head and bleeding from the wound. He had no other obvious injuries. He was brought to the ER by bystanders. On examination, there was ongoing bleeding from his occipital wound. He was found to be under the influence of alcohol and his GCS was 8/15. He was obtunded, responding to pain by flexion of hands and opening of eyes. His pupils were bilaterally equal and reacting. His wound was cleaned, bleeder identified and ligated. He was intubated with Cervical spine (C-spine) protection and a cervical collar was applied. A noncontrast CT(NCCT) scan of the brain and screening of spine were done which showed a large extradural hematoma over the right parietal region with 11 mm midline shift and screening of spine was normal. Relatives were anxious to know his prognosis and outcome.