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MRI of brain post accident shows contusions and intaventricular hemorrhage, hyponatremia was corrected. What is going on?

Respected Sir/Madam, New Year Greetings! Well. I am Anandhan.T, doing Ph.D in Plant Breeding and Genetics at Tamil Nadu Agricultural University, Coimbatore. Discharge summary S.Chinnammal (My Grandma), age-65, Alleged Road accident on 30.9.12. Relevant investigations were done at Cauvery Hospital, Trichy. Physicians opinions were sought. CT scan- brain shows SAH with IVH and greater wing of sphenoid on right side. MRI –brain shows bilateral frontal lobe; left thalamic and pontine contusions and intaventricular hemorrhage. She was treated conservatively in view of Diffuse Axonal injury and due to expected delayed recover patient underwent tracheostomy following intubation for air way protection. Her hyponatremia was corrected appropriately. She was treated with I.V fluids, RT feeds, antibiotic, anticonvulsants, diuretics and other supportive measures. Physiotheraphy was given. She is being discharged gradually on 26.10.12 with on Ryles tube feeding, on CBD, on Tracheostomy. There after once in 15 days she went for review. After checking vital parameter, on the same day, she discharged from the hospital. Likewise, she went for last review on 6.1.2013. CT scan- brain shows tiny petechial hemorrhage seen in the left parietal region and Age related volume loss of the brain Parenchyma with prominent tetra ventricular systems, cisterns and sculal spaces. Doctor advised the treatment of shunt . Dr.M. Vikram, MB., DNB., MNAMS., Cauvery hospital, Trichy Hence, here I kindly request you to please give your valuable suggestion to cure this illness . I am looking forward your reply. Thanking you,
Asked On : Sat, 19 Jan 2013
Answers:  1 Views:  156
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Neurologist 's  Response
Nov 2013

Thank you for sending the discharge summary.

This is a case of road traffic accident with multiple head injuries.

It was a severe head injury and more than four months have passed since.

At this stage, the most important aspect of her care is physiotherapy along with good nursing care.

Importance should also be given to feeding and nutrition.

Only medication that may be required is anti epileptic medications.

Please discuss these aspects of her care with her neurologist/neurosurgeon.

Best wishes,
Dr Sudhir KumarMD DM (Neurology)
Senior Consultant Neurologist
Answered: Sun, 10 Feb 2013
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