A 27-year-old woman, 27 weeks old, wearing a seat belt, driver, who had a frontal shock against another vehicle in a fertility treatment maneuver, presented cranioencephalic trauma with loss of consciousness.
The emergency department presented a Glasgow coma scale score of 15; 90 minutes after the accident, the patient developed dysarthria and aphasia, and no obstetric problems were observed.
He was admitted to the ICU 2h and 15min after the accident, with motor aphasia, proximal right hemiplegia and extensor right plantar cutaneous reflex, skin mark of the seat belt in the left lateral cervical region and in the abdomen.
A CT scan and an extracranial ultrasound scan were performed without pathological findings.
At 18h, a cranial magnetic resonance imaging (MRI) of the cervical spine was performed, as well as an angioresonance (angio-MRI) of the left supra-aortic trunks and left intracranial arteries showed a decrease in size.
Antiplatelet aggregation was started with 200mg of ASA.
A dead fetus was detected by ultrasound and a cesarean section was performed 24h later.
1.
At hospital discharge, two weeks after the accident, she had minimal dysphasia with motor predominance, and proximal 3/5 hemiparesis in the right upper limb and 0/5 distal dysphasia in the right lower limb.
