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Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
The patient was a 17 month old female who fell down 12 steps in her grandmother's arms with the grandmother landing on the child's head and smothering her.
Clinical Physical Exam:
The patient had abnormal posturing and a blown left pupil.
Clinical Differential Diagnosis:
Diffuse cerebral edema
Chest film showed air in the mediastinum. Head CT exam showed diffuse cerebral edema and left contusion, subarachnoid hemorrhage, a frontal skull fracture, and air dissecting in the neck. An abdomen CT exam showed air in the mediastinum and a small right pneumothorax.
Imaging Differential Diagnosis:
Follow-up and Prognosis:
The patient was felt to be brain dead and had a nuclear medicine brain scan which confirmed the diagnosis. She was taken off of life support and died.
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