Nepean Hospital

  • 67-year-old male, re-admitted to ICU 26 days earlier following a MET call for reduced level of consciousness. He was admitted initially post decompressive craniotomy for a spontaneous SDH and his first ICU stay had been complicated by refractory intracranial hypertension, failed extubation, non-convulsive status epilepticus and DVTs. Clinical findings included right hemiparesis and the presence of a right-sided craniectomy and a tracheostomy. Candidates were asked to examine him and assess whether he was ready for discharge to the ward. Further discussion points included interpretation of CT and MRI brain, the discrepancy between the anatomical site of the SDH and clinical findings, management of tracheostomy, DVT prevention and management and prognosis.