A 40 years old male patient presented to our ED for dizziness, head trauma and left ear haemorrhage. He drank some alcohol then he had dizziness and fall down, like he said he got loss of conscious for few minutes . On examination: he has vital stable, some blood from left ear, stopped after that and unremarkable physical examination. The ethanol level was 26 that not much high and CT head decided. The report of CT head mentioned normal variation without skull fracture or brain haemorrhage, so the patient got supportive treatment and went to home. After 6 days, he came back with left facial palsy and headache . On examination the left facial palsy is result of lower motor neuron lesion because affected the left eye with left upper face and the left side of the mouth with left lower face. No left ear haemorrhage at that time. CT head decided again that report mentioned : Acute intraparenchymal haemorrhage is seen in the right temporal lobe, measuring about 16 x 15 x 12 mm in AP, TR sequences respectively, with surrounding oedema , also left petrous bone fracture . During the examination the patient had: LEFT EAR HEMATOMA NOTED WITH TYMPANIC MEMBRANE BULGE NOTED.Back to the first CT scan , the report mentioned nothing but the CT film showed small left temporal haemorrhage and left petrous bone fracture that missed by radiologist . The patient got admission by neurosurgical team , no surgical intervention done for him , just he got admission for some days for observation then discharge , the symptoms relief after that . Two months after, he did CT head that showed total resolution of the previous CT finding.
Smart Citations