ABSTRACT
This chapter presents a case study of a 35-year-old man who is the unrestrained driver in a head-on motor vehicle accident. The basic principles of Advanced Trauma Life Support (ATLS) should be followed – Airway with cervical spine immobilisation, Breathing and Circulation, in that order, should take priority over obtaining the computed tomography (CT) head. In this case, the patient's CT scan of the head shows a hyperdense crescent-shaped area beneath the skull, causing mass effect on the underlying brain parenchyma. Depending on the extent of the injury and the amount of space in the cranial vault, the patient could remain neurologically stable or could deteriorate as evidenced by a drop in the Glasgow Coma Scale (GCS) and development of a motor deficit. Depending on the local practice patterns, the neurosurgeon may or may not be a part of the initial trauma team evaluating the patient on arrival.
