A 2-Year-Old With Intracranial Hemorrhage

Authors: Jamie Hixon, MD; Stefanos Intzes, MD; Gautam Malkani, MD Series Editor: Sheryl A. Falkos, MD; Rosa A. Vidal, MD


August 07, 2006


Physical Examination

General appearance: Patient intubated and sedated

Vital signs: T 99.8°F, HR 191, respiratory rate 18, BP 90/61 mm Hg

HEENT: Head normocephalic and atraumatic; pupils equal and reactive to light at 3 mm in size bilaterally, no icterus; endotracheal tube in place

Cardiac: Regular rate and rhythm, 2/6 systolic ejection murmur

Respiratory: Upper airway sounds transmitted throughout, good bilateral breath sounds

Abdomen: Soft, nontender, nondistended, active bowel sounds; without hepatosplenomegaly

Extremities: No clubbing, cyanosis, or edema. Good peripheral pulses. Capillary refill 2-3 seconds. No rashes noted.

Neurologic: Spontaneous eye movement. Moving all extremities in a purposeful manner. Glasgow coma score 7.

Initial Laboratory Analyses

CBC with differential: Hemoglobin 8.5 g/L, hematocrit 25%, platelets 143,000; total white blood count 16,800 with 92% granulocytes, 0% bands, 4% lymphocytes

Metabolic profile: Within normal limits

Arterial blood gas: pH 7.39, pCO2 35, pO2 61, HCO3 21

Coagulation panel: PT 13.6, PTT 35, INR 1, fibrinogen 540

Radiologic Evaluation

Figure 1.

CT scan of the brain showing left frontal temporal hemorrhage.

Figure 2.

CT scan of the brain showing left frontal temporal hemorrhage.


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