My childhood friend met with a major accident last week and has been unconsious since last 7 days. Below are the 2 reports for CT scan and Angiography. Although the docs did explain us what the current state of my friend is. I would like to understand the below reports in simple/layman's terms. Thanks in advance. Please pray for my friend to get better thanks/
CT SCAN OF BRAIN (Plain Study)
-------------------------------- Above study was performed on 64 slice MDCT unit and appropriate hard copy documentation done.
Multiple Intraparenchymal hemorrhagic contusion with perifocal edema seen in left fronto-temporo-parietal, left cerebellar hemisphere, pons & mid brain regions. EDH of maximum thickness 4 mm along left anterior basitemporal region. Hemorrhagic hyperdensity also seen along superficial sulci gyri, right posterior parietal region & adjacent interhemispheric region S/o SAH.
Soft tissue swelling seen in bilateral partiel, left fronto-temporal region and maxillo-facial region.
Multiple comminuted fracture seen in left zygomatic arch, zygometic process of temporal bone, wall of left maxillary sinus, left inferior and lateral orbital wall, left ramous of mandible, wall of sphenoid sinus, left greater wing of sphenoid bone, right mastoid, right peterous with adjacent soft tissue injury.
Hemorrhagic hyperdensity seen in all sinuses S/o organized Panhemosinus.
Rest of the cerebral panrechyma appears normal.
Ventricular system and cisterns are within normal limit.
There is no shift of midline structures.
Above study was performed on 64 slice MDCT unit and appropriate hard copy documentation done using various post-processing techniques. Post I. V. contrast study was done after injecting non-ionic contrast under the care of anaesthetist.
Significant post traumatic thrombotic stenosis of left supraclinoid ICA approx. 5 mm long segment with post stenotic dilatation & reformation of ICA bifurcation through it is COW collaterals.
Early cavernous sinus contrast filling in arterial phase in left side compare to right side S/o carotid cavernous fistula formation.
Post traumatic small saccular aneurysmal dilatation measuring approx. 3.8 x 3.6 x 2.9 mm seen at left cavernous ICA extending anterior inferior medially with in left sphenoidal sinus.
Right internal carotid artery shows a normal intra cranial course and division into anterior and middle cerebral. The ACA & MCA show normal branching.
Basilar artery and the posterior cerebral arteries are also normal in course and calibre. Circle of Willis is well defined. The arterial branching pattern is normal.
Unfortunately, your friend has suffered severe trauma to the head and face, resulting in multiple brain "bruises" (concussions), swelling, blood in sinuses, and a clot in one of the arteries. There are numerous facial fractures involving the eye socket, sinus walls, cheekbone, and behind the ear. These may require surgery or heal on own depending on how displaced they are. The swelling should go down, and bruises will heal, but this will take most likely a month or two. The blood clot may resorb with time, also a few weeks to months. Your friend may have residual neurological deficits and require lengthy rehab to regain motor function and speech/language/visual/auditory function. One never really knows the outcome until you get there timewise. I hope your friend recovers well and has good neurologists for care now and rehab later. It is very difficult to see someone you care about in this situation, and the uncertainty of outcome and length of time to recover is very stressful for all. Keeping a journal of progress can help, as it occurs in small increments, but it will keep you focused on the positive, and be a record for your friend of what went on during the coma period. Prayers and hugs to you and friend/family.
The Following User Says Thank You to ladybud For This Useful Post: mjsumank (07-31-2012)
Thank you so much for your quick and detailed response. It is indeed a dificult time for his family and friends. In my last conversation with the Radiologist, he explained that a nerve/artery (i'm not good with medical terms) on the left side of the brain is blocked or damaged which has stopped the blood flow to portion of the brain which handles motor skills, speech etc. This is the one of the reason he is not able to regain conciousness. The docs have mentioned the priority is to get him consious.
He does move his limbs on his own regulary. But if we hit or pinch him his body does not react. There is little movement in the right pupil since yesterday. I have the images of his report and X ray of his head however i have no way to attach and image here. Is there a way i can send it to you. I'm sorry for being desperate but i want to make sure a do everything possible to help my friend get better. Thank you
Actually, the written report is more helpful. You can help your friend by talking to him, as the sense of hearing is the last to go when losing consciousness and the first to recover when coming out of coma. Even if he doesn't respond, he may hear you. You can also touch him, and help his family as well. I know you probably feel helpless, but just being there with him and family at times is very helpful. His coma is pretty deep if not responding to pain, but it is good he is moving all extemeties. The brain has safeguards in the circulation to keep blood flowing to areas that may get cut off, so it is more protected from lack of oxygen than most of our parts. Keep us posted on his progress and keeping in mind it will be slow and lengthy will help everyone have patience.