Worsening Headache in Surgery — 45yo Man | Trauma Surgery | SMLE Q#11592
SMLE Question #11592
Surgery
Trauma Surgery
Objective: OBJ-TRM-AIRWAY-01
Last updated: February 2026
A 45-year-old man is brought to the emergency department after a high-speed motor vehicle collision. He becomes progressively drowsy with worsening headache and repeated vomiting. He is intubated for declining mental status. Examination shows a right pupil larger than the left, with both reacting sluggishly to light. The team suspects acute intracranial hypertension while emergent CT imaging is being arranged. What is the most appropriate immediate measure to reduce intracranial pressure?
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