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What Does This CT Scan Report Indicate?
Question: Hello - This question is for my 2 and 1/2 year daughter. she fell down from sofa and CT scan result shows 1. Foci of hyperdensity is seen in righty side periventricular region of HU +52 to +57. s/o? Petechial hemorrhage?
2. Minimal soft tissue swelling in right parietal region.
2. Minimal soft tissue swelling in right parietal region.
Brief Answer:
Prognosis of injury
Detailed Answer:
Hi XXXXXXX thanks for asking from HCM.
I can understand your concern. Your daughter had significant head injury. But good thing is
- Her injury occurred on right side which is non dominant side
- She is having bleed and edema in parietal region which is mostly non dangerous as it does not affect brainstem until bleed is very large. Brainstem compression is life threatening.
- Her edema is minimal. It is good.
To say more, I need some information about
- Size of bleed
- Her consciousness
- Any midline shift
These information will help me in reaching upto some conclusion.
Hope it will help you.
If any doubt, do let me know.
Thanks.
Take care.
Prognosis of injury
Detailed Answer:
Hi XXXXXXX thanks for asking from HCM.
I can understand your concern. Your daughter had significant head injury. But good thing is
- Her injury occurred on right side which is non dominant side
- She is having bleed and edema in parietal region which is mostly non dangerous as it does not affect brainstem until bleed is very large. Brainstem compression is life threatening.
- Her edema is minimal. It is good.
To say more, I need some information about
- Size of bleed
- Her consciousness
- Any midline shift
These information will help me in reaching upto some conclusion.
Hope it will help you.
If any doubt, do let me know.
Thanks.
Take care.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Hello Doctor,
Thank you for the response.
When she fell down yesterday(around 20 hrs from now), she was sort of unconscious and vomited the milk she took afterwards. Hence gone for CT scan.
The CT scan reports the above(problematic findings/conclusion) as i sent earlier along with the below details:
1. cerebellar parentchyma is normal
2. the 4th ventricle is normal
3. the brain stem is normal
4. the 3rd ventricle & lateral ventricles are normal
5. No subdural/extradural haematoma seen
6. Sella region is normal
7. No mid line shift seen
She is now conscious and i was told the size of bleed is around 0.5mm(size of a pin head).
The doctor advised liquid food and gave medicines for 5 days including syrup for vomit, antibiotic and paracetamol as she injured the jaw and it's swelling.
Please let me know, if anything serious. What should i need to be cautious about? How long she needs to be still monitored(some says 72 hours need to be watched but is it the case?) Could it still go on wrong side? will the bleed recover automatically with time? What medications she needs to be given.
Kindly advise.
Thanks.
Thank you for the response.
When she fell down yesterday(around 20 hrs from now), she was sort of unconscious and vomited the milk she took afterwards. Hence gone for CT scan.
The CT scan reports the above(problematic findings/conclusion) as i sent earlier along with the below details:
1. cerebellar parentchyma is normal
2. the 4th ventricle is normal
3. the brain stem is normal
4. the 3rd ventricle & lateral ventricles are normal
5. No subdural/extradural haematoma seen
6. Sella region is normal
7. No mid line shift seen
She is now conscious and i was told the size of bleed is around 0.5mm(size of a pin head).
The doctor advised liquid food and gave medicines for 5 days including syrup for vomit, antibiotic and paracetamol as she injured the jaw and it's swelling.
Please let me know, if anything serious. What should i need to be cautious about? How long she needs to be still monitored(some says 72 hours need to be watched but is it the case?) Could it still go on wrong side? will the bleed recover automatically with time? What medications she needs to be given.
Kindly advise.
Thanks.
Brief Answer:
Good prognosis of your baby girl bleed
Detailed Answer:
Hi XXXXXXX welcome back.
Thank you very much for providing me detailed report. Your daughter will recover completely as
- Her bleed is very small (0.5mm). Brain parenchymal bleed with size more than 2.5cm or significant swelling (your daughter has minimal swelling) or midline shift of more than 5mm (no midline shift in your daughter) are considered dangerous and require monitoring.
And it is right that first 72 hours are most critical. The parenchymal bleed always increase in size and can cause deterioration in first 72 hours. But if bleed is minimal in size, this increase in size does not affect at all. To reduce the re-bleeding, you can do following things
- Give her complete bed rest for 3 days and then allow mild activities like walking, going toilet, watching TV in next 7 days. After that you can allow her routine activities.
- Avoid any further head injury for next 1 week
- Avoid any seizures by giving syrup phenytoin or levetiracetam after proper prescription.
You need not to worry as your daughter is out of danger. She is doing ok for last 20 hours. It is very good. You can monitor her strictly for 72 hours and then keep an eye till 7 days. Then no need of monitoring. Go for follow up after 7 days and 30 days.
: It can go on wrong side if there is seizure attack, recurrent head injury, vomiting and aspiration. SO you need to watch for these and give medication to prevent vomiting and seizures.
: The bleed recovers automatically in next 6 months. After 7 days, risk is minimal. However risk of seizure will always remain there. No body can do anything about it. The risk is less than 1%.
Please do not worry about it. Just follow your doctor advise about follow up.
: At present, she needs
- Antiepileptic drug like syrup phenytoin or levetiracetam for 7 days. If no seizure after 7 days, discontinue it.
- Antiemetic or vomiting control medication like domperidone syrup
- Painkiller medication like syrup Paracetamol+Ibuprofen
Only these medication are needed for 7 days. After that you can continue painkiller if there is persistent headache.
Hope it will help you. Please don't worry.
Thanks. Take care.
Good prognosis of your baby girl bleed
Detailed Answer:
Hi XXXXXXX welcome back.
Thank you very much for providing me detailed report. Your daughter will recover completely as
- Her bleed is very small (0.5mm). Brain parenchymal bleed with size more than 2.5cm or significant swelling (your daughter has minimal swelling) or midline shift of more than 5mm (no midline shift in your daughter) are considered dangerous and require monitoring.
And it is right that first 72 hours are most critical. The parenchymal bleed always increase in size and can cause deterioration in first 72 hours. But if bleed is minimal in size, this increase in size does not affect at all. To reduce the re-bleeding, you can do following things
- Give her complete bed rest for 3 days and then allow mild activities like walking, going toilet, watching TV in next 7 days. After that you can allow her routine activities.
- Avoid any further head injury for next 1 week
- Avoid any seizures by giving syrup phenytoin or levetiracetam after proper prescription.
You need not to worry as your daughter is out of danger. She is doing ok for last 20 hours. It is very good. You can monitor her strictly for 72 hours and then keep an eye till 7 days. Then no need of monitoring. Go for follow up after 7 days and 30 days.
: It can go on wrong side if there is seizure attack, recurrent head injury, vomiting and aspiration. SO you need to watch for these and give medication to prevent vomiting and seizures.
: The bleed recovers automatically in next 6 months. After 7 days, risk is minimal. However risk of seizure will always remain there. No body can do anything about it. The risk is less than 1%.
Please do not worry about it. Just follow your doctor advise about follow up.
: At present, she needs
- Antiepileptic drug like syrup phenytoin or levetiracetam for 7 days. If no seizure after 7 days, discontinue it.
- Antiemetic or vomiting control medication like domperidone syrup
- Painkiller medication like syrup Paracetamol+Ibuprofen
Only these medication are needed for 7 days. After that you can continue painkiller if there is persistent headache.
Hope it will help you. Please don't worry.
Thanks. Take care.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Thank you Doctor.
Kindly let me know if another CT scan is required and when? Is it Ok for her to travel(after 2 days from now?)?
Kindly let me know if another CT scan is required and when? Is it Ok for her to travel(after 2 days from now?)?
Brief Answer:
NEED of CT and travelling
Detailed Answer:
Hi XXXXXXX welcome back.
Another CT head is needed urgently if there is any deterioration of consciousness,
seizures
focal deficit
uncontrolled headache with vomiting
visual loss
altered behaviour
too much sleepy
If no such signs, then get another CT head after 3 days of injury. And after it, if everything is fine, then no need of further CT head.
She can travel after first 72 hours. Make sure if she is travelling, there is neurosurgeon available at other place.
Hope it will help you. Thanks. Take care
NEED of CT and travelling
Detailed Answer:
Hi XXXXXXX welcome back.
Another CT head is needed urgently if there is any deterioration of consciousness,
seizures
focal deficit
uncontrolled headache with vomiting
visual loss
altered behaviour
too much sleepy
If no such signs, then get another CT head after 3 days of injury. And after it, if everything is fine, then no need of further CT head.
She can travel after first 72 hours. Make sure if she is travelling, there is neurosurgeon available at other place.
Hope it will help you. Thanks. Take care
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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