13 Mm Midline Shift in Surgery — 72yo Man | Neurosurgery | SMLE Q#1291
SMLE Question #1291
Surgery
Neurosurgery
Objective: OBJ-310
Last updated: February 2026
A 72-year-old man is brought to the emergency department after falling down stairs. Over several hours, he becomes progressively less responsive and is intubated for airway protection. Examination shows right-sided hemiparesis and a dilated, sluggishly reactive left pupil. Non-contrast head CT demonstrates an acute left subdural hematoma with 13 mm midline shift. What is the most appropriate next step in management?
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