R.T. is a 16-year-old girl who has just received her driver’s license. She has t

Question

R.T. is a 16-year-old girl who has just received her driver’s license. She has taken several friends to a “bush party” at a classmate’s farm where beer and liquor were available. She leaves the party at 2:00 AM after having several drinks Her friends tease her as she attempts to put on her seat belt and one calls her a sissy. She begins driving home without a seat belt. Her car drifts across the median and is involved in a head-on collision. Her most serious problem appears to be severe brain injury following ejection from the car. She is transported to the area trauma center, where treatment begins immediately.

1. Examination indicates papilledema in the right eye, a subdural hematoma in the temporal region, loss of consciousness and decreased responsiveness to painful stimuli. Explain how each symptom or sign is related to increased intracranial pressure?

2. Describe a subdural hematoma, its location, and how it developed and cause ICP?

3. R.T. develops bilaterally dilated pupils and a CT scan shows ventricular shift. What are the implications of these findings?

4. Surgery is performed to reduce the pressure in her cranium and R.T. recovers but requires rehabilitation for several deficits, including problems with hearing and memory as well as comprehension of speech. How will these deficits affect her academic work? Which regions of the cortex have been damaged?

One year after the accident R.T. returns to high school and with the aid of a special education program for with head injuries, she graduates.

Explanation / Answer

1) The person who is effected with intercranial pressure (ICP) will have symptoms like headache,increase of blood pressure,vomtings,confusion about time and confusion about the locations, some times pupils doesn't respond to light etc..The person suffering with ICP,when light get incident on his eyes,his pupils doesn't respond to the changes of that light and there starts a state of confusion about is location,time,date and this might leads to headache and also vomting.Mental stress joins along with these symptoms which makes his confidence levels decreases.These are the major symptoms experienced by the ICP patient.

2) Subdural hematoma is associated with traumatic brain injury where the gathering of blood takes place between arachnoid matter and dura matter.Subdural hematoma may also leads to the increase of intercranial blood pressure(ICP) which leads to the damage of brain tissues.The location of subdural hematoma is in between dura matter and archanoid region.There are several causes of ICP,they are tumors,strokes,accumulation of spinal fluid in brain cavities,hypertensive brain injury will leads to the bleeding of brain.All these are the cause of the intercranial pressure.

3) Dilated pupil which is greater than 5 mm doesn't react to the bright light.This is the main symptom of patients effected with the dilated pupil.

4) As her eyes were effected with R.T and she also suffered with cranium pressure,she needs to take rest for few months because rest is the only remedy for this case,Ofcourse there is a loss of her academic career but health is most important than her academics.

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