By Senior Registrar Department of Anaesthesia Nian Chih Hwang, Peng Jin London Lucien Ooi
International specialists in illnesses of the adrenal glands current new clinical facts and useful instructions for surgeons, citizens, endocrinologists and training physicians. The ebook covers all facets of adrenal gland illnesses in nice aspect. comprises approx. 2 hundred illustrations comparable to radiographs, CTMRI pictures, graphs and microscopic pathological slides, and so forth. numerous tables and colour illustrations of surgical concepts with emphasis at the laparoscopic method are incorporated.
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Extra resources for Acute Surgical Management
This can sometimes occur slowly so that there is a lucid interval. Prognosis can be good if the clot is evacuated early. (2) Bleeding from underlying damaged brain matter. The prognosis depends on the underlying brain damage, as well as any delay in evacuating the clot. Acute Management of Head Injuries 21 CT scan of bilateral acute subdural haematomas. CT scan of a brain contusion: on first day, and after 24 hours. Intracerebral contusions These typically occur in the frontal and temporal lobes, probably due to the bony prominences in the floor of the anterior and middle cranial fossae.
The overwhelming need is to reduce intracranial pressure (ICP) until definitive treatment can be provided. This can be done by hyperventilating the patient, administering osmotherapy (mannitol), elevating the head of the patient, and in certain situations, administering steroids. The role of prophylactic anticonvulsants is somewhat controversial. However, when there has been a clearly witnessed convulsion, there is no doubt that medication should be started. Similarly, in cases where there is the likelihood of seizures (such as compound depressed fractures or temporal lobe tumours), or where neurosurgical intervention is imminent, anticonvulsants should also be started.
Of note are the “shaken baby” syndrome and “ping-pong” fractures in infants; Paediatric Neurosurgical Emergencies 43 “growing” fractures in young children; and “paediatric concussion” syndrome in the older child. 12 There is often a doubtful history of minor trauma or no trauma; seizures; apnoea; evidence of blunt impact to the head; skeletal or soft tissue injuries; and retinal haemorrhage. In the acute stage, CT scan findings typically show subarachnoid haemorrhage or acute subdural haematomas (Fig.