Case 281 Medical History 80 years-old female patient complains of asthenia and mental confusion with progressive worsening for 24 hours associated with headache and spatial and temporal disorientation. There is a report of a fall from hers own height two weeks ago, with an injury (a cut) in the frontal region. Previous history of ischemic stroke one year ago, presenting a motor sequel in the left dimidium. Imagem 1: Noncontrast computed tomography (CT) scan of the head, axial section.Imagem 2: Nonconstrast computed tomography (CT) scan of the head, coronal reconstruction. Pergunta:According to the clinical case and the images provided, what is the most likely diagnose and the best approach? Subacute subdural hematoma - refer the patient to emergency surgery for hematoma drainage. Epidural hematoma - refer the patient to emergency surgery for hematoma drainage. Subacute ischemic stroke - initiate thrombolysis with r-tPa and refer the patient to the Intensive Care Unit. Precocious subacute hemorrhagic stroke - refer the patient to emergency surgery for aneurysm clipping. Test Question (Santa Casa / RJ - 1994) A 68 year old patient with cerebral atherosclerosis presents with mental confusion, headache and somnolence, 15 days after falling on the stairs of his residence. What is the most likely injury? Brain concussion. Brain contusion. Epidural Hemorrhage. Subdural hemorrhage. Time is Up! Time's up
