Patient with Severe Traumatic Brain Injury and Malaria in a Middle Eastern Country

Patient is a 38-year-old male who recently travelled from Uganda to Qatar with history of fever, headache, and abdominal pain. Patient was feeling dizzy and fell down while trying to walk up to the toilet. His initial Glasgow Coma Score (GCS) reported to be 15/15 with bilaterally reactive pupils. Patient’s GCS dropped rapidly during the transport to trauma resuscitation unit. On arrival in trauma resuscitation unit patient developed anisocoria with a GCS of 3/15 and was intubated with rapid sequence intubation. An urgent trauma whole body CT scan revealed a large subdural haemato-hygroma causing mid-line shift of 16 mm and multiple frontal and temporal contusions with effacement of basal cisterns (Figs 1A and B). Admission CT also showed a subtle hypodensity in the posterior cerebral artery territory (Fig. 1C). Patient was taken for a lifesaving evacuation of subdural hematoma. In view of the history of travel, fever and low platelets on presentation, malaria screen was also performed in addition to routine BaC kg r o u n D