Case of the Month #39 Traumatic Brain Injury

Published 25/05/2023


Theme: Neuro 

A 23-year-old man presents to A&E having sustained a blunt force trauma to his head outside a nightclub. On arrival, he has just vomited for the second time and is confused. He is aggressive and claims not to remember the events. He shouts at you that he has no other medical problems, and no collateral history is available. 

There is an obvious red swelling above his right brow ridge. There is a substantial ecchymosis overlying the right orbit. His GCS is E4V4M6, and you observe him moving all his limbs. His agitation precludes a formal neurological examination. His heart rate is 120/min, though all of his other observations are normal.