
Originally Posted by
Kristof_F40
Guys, I don't want to spoil the party, but don't become to optemistic. What happened is this: MSC had an extradural hematome which is a blood clot between the skull and the dura mater, it's extracerebral. The problem with such hematome is that is an extra volume in a closed space, therefore the brain tissue is compressed which can lead to SECONDARY problems. What you want to do is to minimize these SECONDARY problems, this is done by contorlling ICP (intracranial pressure). This is the only goal for the medics at this point. Yesterday MSC was very unstable which means that ICP can change very dramticly very fast. Now they have removed this extradural hematome, this procedure was done successfully. This means that this hematome is fully removed and can't cause extra pressure and therefore secondary problems. Nevertheless, this hematome isn't the only "thing" that can cause extra pressure and therefore increase ICP. If the brain is injured it starts to swell, thus extra volume thus extra ICP. Therefore the medics have placed a "drain", which will allow the brain to swell without causing a big increase in ICP. So what they are saying now is there is a bit more control over his ICP, which is good to control the SECONDARY problems.
But there isn't an absolute control. Which means they still need to control the different parameters, ventillation, ICP, ... His condition is therefore still critic. IF everything stay stable, maybe the swelling dissapears, than the risk of increased ICP is lower, and lower risk on SECONDARY problems. We have to wait to now this for sure.
But! except for this extradural hematome, there are also diffuse INTRACEREBRAL bleedings, which our bleeding in the brain tissue it self, this can't be drained as easily, and they are not doing this. So these bleedings are still in his brain, hopefully they will start dissappearing spontanously.
So, the docters are now trying to get him stable and make sure SECONDARY problems don't develop. However, because of the diffuse intracerebral bleedings (due to contusion) there is also PRIMARY damage. We don't now which regions are damaged, and how badly so we can't say anything about this. So what the docters are doing is trying to stabilize ICP to reduce chance of secndary problems, they did the operation in order to do so (this is not the only thing they do), but there is still primary damage, something they are NOT "concerned", if risk for secondary problems is gone, than they start looking at what is damaged...
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