tag:blogger.com,1999:blog-2186593343917545414.post5556417529389920502..comments2024-03-10T12:29:30.004-07:00Comments on pediatric neurology: A 2-foot fallGalen Breningstall, MDhttp://www.blogger.com/profile/07170864203251456228noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-2186593343917545414.post-59090733546050421672018-06-13T10:51:20.444-07:002018-06-13T10:51:20.444-07:00A 6-month-old infant in good health previously the...A 6-month-old infant in good health previously the day prior to admission fell from a bed to a wood floor, a height of about 3 feet. He cried immediately, but was consolable. For a period of time after that, he was somewhat sleepy and did not look right to mother and so she brought him in to urgent care. There, he was looked over and had perked up considerably in the interim and so was discharged to home with instructions to call 911 if he deteriorated. He was crabby and wanted to be held most of the night, but into the morning he became much more sleepy and refused to try food and would not open his eyes as much. Mother became more concerned and returned to urgent care; however, it was closed and so she called 911 from the parking lot with the assistance of a passerby. EMS (emergency medical service) arrived and placed an intraosseous line and transported him urgently to an emergency department, where a trauma team activation was done. In the trauma bay, he was noted to be arousable and would move all of his extremities with stimulation, but his upper extremities and left lower, he would move spontaneously, right lower only with stimulation and a bit stiffly and slowly. He was noted at the scene to have a dilated left pupil at about 6 mm. He was taken, shortly after arrival, to the CT scanner, where a large epidural with significant midline shift was noted. Following evacuation of the epidural hematoma, he had a head CT, which revealed concern for ischemic injury in the left hemisphere in the distribution of the middle cerebral artery and the posterior cerebral artery. A follow up MRI was obtained on day 10, which again revealed infarcts of the left MCA and PCA and residual subdural hematomas. Galen Breningstall, MDhttps://www.blogger.com/profile/07170864203251456228noreply@blogger.com