No Witnessed Loss Of in Surgery — 7yo Child | Neurosurgery | SMLE Q#19210
SMLE Question #19210
Surgery
Neurosurgery
Objective: OBJ-NEURO-TRAUMA-EDH-001
Last updated: April 2026
A 7-year-old boy is brought to the emergency department after falling off a bicycle and striking the side of his head. He cried immediately with no witnessed loss of consciousness. Two hours later, he is drowsy and not fully alert. Examination shows GCS 13 (E3 V4 M6), pupils equal and reactive, and no focal motor deficits. Non-contrast head CT shows a hyperdense biconvex extra-axial collection in the temporal region with mild midline shift. What is the most appropriate next step in management?
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