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Deterioration following craniectomy
  1. Mariam Annan1,2,
  2. Claudine Martin3,
  3. Maelle Dejobert2,4,
  4. Bertrand de Toffol1,2,
  5. Caroline Hommet2,5,6,
  6. Karl Mondon2,5,6
  1. 1Department of Neurology, CHRU Tours, Tours, France
  2. 2Université François Rabelais, Tours, France
  3. 3Functional Rehabilitation Center, Bel Air, La Membrolle sur Choisille, France
  4. 4Department of Neuroradiology, CHRU Tours, Tours, France
  5. 5Memory Clinic and Geriatric Medicine Department, CHRU Tours, Tours, France
  6. 6INSERM U930, Tours, France
  1. Correspondence to Mariam Annan, Department of Neurology, CHRU Bretonneau, 2 boulevard Tonnelle, 37044 Tours Cedex 9, France; mariam.annan{at}

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A 35-year-old right-handed man was admitted to the rehabilitation unit, 4 weeks after a traumatic brain injury. He had been found unconscious in the street several hours after drinking with friends. On first admission to the emergency unit, his Glasgow Coma Scale score was 6 out of 15. His CT scan of head showed an occipital condyle fracture, an acute right subdural haematoma, bifrontal intraparenchymal and subarachnoid haemorrhage, and right hemisphere oedema. A few hours following intensive care unit admission, he developed a right reactive mydriasis. His intracranial pressure remained high despite osmotherapy, and he underwent decompressive craniectomy with subdural …

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  • Contributors MA: drafted the manuscript. CM: took care of the patient. MD: took care of the patient, interpreted brain imaging. BdT: revised the manuscript and approved the final version. CH: revised the final version. KM: revised and approved the final version.

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Andreas Demetriades, London, UK.

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