Drainage From Cranial Incision

Consult Page

47F with recent brain surgery presenting with drainage from wound

Initial Imaging

Walking Thoughts

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  What was the patient’s prior surgery? When was the surgery?

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  How was the patient’s postoperative course?

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  How long has the patient had drainage from the incision?

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  Is there wound dehiscence? If so, is it deep or superficial?

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  What does the drainage look like (e.g. purulent vs. serous vs. bloody)? Is there a CSF leak?

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  Does the patient have fevers, chills, meningitis, or other systemic signs of infection?

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  What is the patient’s current neurological exam? Are there any deficits to suggest intracranial involvement?

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  Does the patient have any risk factors for poor wound healing or infection (e.g. diabetes, obesity, smoking, cancer history, prior radiation)?

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  Were there any intraoperative risk factors for infection (e.g. prolonged case, use of implants, revision surgery, prior infection)?