A 48 year old man presents to your emergency department via ambulance following a syncopal episode. He is confused with a GCS of 12 (M – 5, V – 4, E – 3). His observations, otherwise, are within normal limits. He has had a CT scan of his head performed.
Question
a. Describe and interpret his CT scan. (50%) b. List what features you would seek on history in this man. (50%)
Answer
FACEM VAQ Exam 2005.1 – Question 5
- The overall pass rate for this question was 40 / 44 (90.9%).
- The CT image shows an apparently extra-axial, unilateral mass of mixed attenuation.
- The expectation was that candidates would comment on the mixed density extra–axial collection which had the typical appearances of an extradural haematoma.
- History would have been more difficult to obtain in this patient as he has a GCS of 12 but needed to be relevant to the stated scenario and so include consideration of issues such as trauma, bleeding diathesis, epilepsy and alcohol abuse as well as the usual key history questions.
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