Worsening Headache in Surgery — 24yo Man | Neurosurgery | SMLE Q#19474
SMLE Question #19474
Surgery
Neurosurgery
Objective: OBJ-NEUROTRAUMA-EDH-001
Last updated: April 2026
A 24-year-old man is brought to the emergency department after a high-speed motor vehicle collision. He had brief loss of consciousness, was initially alert, then over 1 hour became progressively drowsy with worsening headache and repeated vomiting. He localizes pain on the left and has a right dilated pupil with sluggish light reaction. Non-contrast CT head shows a right temporoparietal biconvex hyperdense extra-axial collection with 8 mm midline shift. What is the most appropriate next step in management?
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