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Case 59 

Case 59
Chapter:
Case 59
Author(s):

Harutomo Hasegawa

, Matthew Crocker

, and Pawan Singh Minhas

DOI:
10.1093/med/9780199599837.003.0059
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date: 17 October 2018

A district general hospital refers a 30-year-old woman who presented to the emergency department following three generalized tonic–clonic seizures. She has a VP shunt which was inserted following traumatic intracranial haemorrhage at 15 months of age. She has had numerous shunt revisions, the last of which was 3 months ago. For the past 2 days, her family noted that she was quiet and not her usual self, although she herself did not complain of any symptoms. On arrival at the local emergency department she was post-ictal and drowsy but responsive with a GCS of 12/15 (E3, V3, M6). During assessment she deteriorates to a GCS of 3/15 and is intubated. Her pupils are size 3, equal and reactive. Her CT scan is shown in Fig. 59.1.

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