Case 2

Harutomo Hasegawa, Matthew Crocker and Pawan Singh Minhas

in Oxford Case Histories in Neurosurgery

Published on behalf of Oxford University Press

Published in print March 2013 | ISBN: 9780199599837
Published online April 2013 | e-ISBN: 9780191753503 | DOI:

Series: Oxford Case Histories

Case 2

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  • Neurosurgery
  • Trauma and Orthopaedic Surgery
  • Clinical Radiology


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You are the neurosurgeon on call and receive a referral concerning a 20-year-old man who is admitted to the local emergency department following a road traffic accident. He was the front-seat passenger in a car travelling at approximately 70km/hour when it skidded and hit a stationary car head on. He was not wearing a seatbelt and his head hit the windscreen. According to the ambulance crew his GCS was 3 at the scene and his pupils were equal and reacting. On arrival in the local emergency department he is intubated and ventilated and his cervical spine is immobilized with a collar and blocks. His GCS is 3 and his pupils are both 5mm in diameter. The right pupil constricts to light but the left does not.

Chapter.  2213 words.  Illustrated.

Subjects: Neurosurgery ; Trauma and Orthopaedic Surgery ; Clinical Radiology

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