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Loss Of Consciousness After Bike Accident


Consult Page

11 yo healthy F, fall from bike with skull fracture

Initial Imaging

Fig. 52.1, Initial head CT without contrast. A. Axial view, bone window demonstrating a left temporal bone fracture extending to the skull base. B. Axial view, parenchymal window demonstrating a 6 mm epidural hematoma overlying the left temporoparietal convexity with a focus of pneumocephalus. C. Axial view, parenchymal window demonstrating a small contrecoup right parietal convexity hemorrhagic contusion measuring 4 mm. D. CT 3D reconstruction of the skull highlighting the left parietal and temporal fractures.

Walking Thoughts

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    What is the patient’s GCS and neurological status?

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    What is the mechanism of injury?

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    Does the patient have any other injuries? Has the patient been evaluated by the trauma team?

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    What was the patient’s condition immediately after the injury?

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    How large is the fracture? Is it open or closed?

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    Are there any associated intracranial injuries?

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    Is there concomitant cervical spine injury that must be considered?

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    Is there any concern for nonaccidental trauma?

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