March 12, 2010

Neurosurgery OSCE Quiz

12 years old Malay boy with history of Pilocytic astrocytoma and completed chemotherapy with insertion of VP shunt 3 years ago was brought to casualty because of loss of consciousness just before the presentation.

Patient is co-morbidly well until yesterday whereby he becomes more lethargic and vomit for four times. He also develops fitting but his mother unable to describe the nature of the fitting.

His GCS on arrival is 7, E1 V1 M5. In view of his condition, intubation was done.

His FBC result is as follow; WBC 18.0 X109/L, HB 13.2 g/dL, Plt 557 X109/L

Below is the picture of his CT scan

picture A

picture A


1) Outline your findings in his CT Scan

2) What is your Provisional diagnosis?

3) What is your next management?

For answer to this question, click [here]

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