02-08-2007, 09:40 AM
is brought to the ER for severe vomiting over the past 6 hours. The mother tells the physician tha she has vomited at least 4 times during this period. She also noticed the infant was having difficulty feeding for 2 days. On examination, she is very fussy, and there is a swelling over the left side of the head. CT of the head shows a skull fracture of the left parietal bone with no evidence of intracranial damage. The mother explains that the baby rolled off the sofa onto the floor yesterday. Which of the following is the most appropriate next step in the management?
A) discharge the patient home with the instructions concerning post concussion symptoms
B) monitor the infant for 12 hours for signs of increased intracranial pressure, discharge the patient home if asymptomatic thereafter
C) obtain the neurosurgical consultation for the skull fracture.
D) obtain a skeletal survey
E) repeat the CT scan of the head in 24 hours
A) discharge the patient home with the instructions concerning post concussion symptoms
B) monitor the infant for 12 hours for signs of increased intracranial pressure, discharge the patient home if asymptomatic thereafter
C) obtain the neurosurgical consultation for the skull fracture.
D) obtain a skeletal survey
E) repeat the CT scan of the head in 24 hours