Right Hemicraniectomy | Figure 1

Right Hemicraniectomy

40's year old motorcycle crash. Moderate speed (~40 mph), no helmet. Initial GCS 10, Pupil asymmetry, right pupil 5 mm sluggish, left pupil 2 mm sluggish. Taken to OR for right hemicraniectomy. In first picture, you can see how red the brain is (subarachnoid hemorrhage). In second picture, you can see the degree of cerebral edema by how far apart the dural edges are. There is a dural graft substitute that is underneath the native dura. Pt was extubated on POD #3, continued pupil asymmetry, mile left arm weakness. Plans to go to neurocognitive rehabilitation and cranioplasty in several weeks.