Examination indicates papilledema in the right eye, a subdural hematoma in the temporal region, loss of consciousness and decreased responsiveness to painful stimuli

R.T. is a 16-year-old girl who has just received her driver license. She has taken several friends to a bush party at a classmate farm where beer and liquor were available. She leaves the party at 2:00AM after having several drinks. Her friends tease her as she attempts to put on her seat belt and one calls her a sissy. She begins driving home without a seat belt. Her car drifts across the median and is involved in a head-on collision. Her most serious problem appears to be severe brain injury following ejection from the car. She is transported to the area trauma center, where treatment begins immediately.

1. Examination indicates papilledema in the right eye, a subdural hematoma in the temporal region, loss of consciousness and decreased responsiveness to painful stimuli. Explain how each symptom or sign is related to increased intracranial pressure.

2. Describe a subdural hematoma, its location, and how it developed and caused ICP.

3. R.T develops bilaterally dilated pupils and a CT scan shows ventricular shift. What are the implications of these findings?

4. Surgery is performed to reduce the pressure in her cranium and R.T. recovers but requires rehabilitation for several deficits, including problems with hearing and memory as well as comprehension of speech. How will these deficits affect her academic work? Which regions of the cortex have been damaged?

One year after the accident, R.T. returns to high school and with the aid of a special education program for with head injuries, she graduates.