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-s & s: hemorrhagic shock, abdominal pain, distension, LUQ abdominal pain, sometimes radiates to the left shoulder
-major consequence: hemorrhage into the peritoneal cavity
-treatment: observation, angioembolization, sometimes surgical repair or splenectomy

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Intraoperative risks for Transgender pts

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Intraoperative risks for Transgender pts

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-Increase risk of DVT and PE due to use of estrogen
-Population at increased rates of anxiety and depression -> sx can worsen these symptoms -> can delay recovery

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-important for clinicians to understand how population responds to such violence & their clinical needs
-safe environment (preferred name & pronouns, gender-neutral bathrooms)
-social support: connect with people who can normalize & validate their experiences (support groups)
-use inclusive language & paperwork
-address safety & self-care
-help clients learn to trust themselves
-advocate for transgender survivors of trauma at various systemic levels

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Animal studies have shown the following:
-Estrogen enhances cardiovascular performance by increasing CO as well as kidney and liver perfusion in the case of severe hemorrhage.
-Estrogen can lessen TBI-based loss of brain function
-ICP and CPP values improved with estrogen use

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Patients should be positioned with their head elevated above the heart to increase venous outflow

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A SDH can impair the patient’s mobility, causing a risk for a venous thromboembolism

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-emotional distress
-poor mental health functioning
-linked to major depression --> 4-7 times more likely than general population
-PTSD
-psychiatric symptoms (mood disorders & anxiety disorders)

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Seizure prophylaxis should be administered to prevent the risks of seizures

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Patients with acute SDH can present with seizures or status epilepticus. Risk factors for acute SDH associated seizures include lower Glasgow coma scale score and the need for surgical evacuation with craniotomy

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HCP education, non discriminatory policies, building trust through active changes, inclusive office practices

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Severe brain swelling

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Clinical signs of elevated ICP are headaches, respiratory depression, hypertension, depressed level of consciousness, and pupillary abnormalities which should be addressed with pharmacologic and surgical interventions

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Feminizing hormone therapy:
Development of female secondary sex characteristics & suppression/minimization of male secondary sex characteristics.
-17-beta estradiol (estrogen)
-Antiandrogens (ex. spironolactone)
-Progestins

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Stigmatization, insufficient insurance coverage, inadequate care from HCPs due to inexperience

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ICP monitoring is recommended for all patients with a SDH. A ICP goal ≤22 mmHg is recommended

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Based on the pathology of the brain during operation

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A computed tomography scan of the head is widely used for imaging acute head trauma due to its speed, simplicity, and widespread availability. CT imaging can provide information on the size of the hematoma, chronicity of the bleeding, midline shifting, and trapping of the ventricles

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Patients with acute posterior fossa SDH may present with vomiting, cranial nerve deficits, cerebellar symptoms, and a headache which are referable to the location of the SDH

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When symptoms appear within 3 days of the bleeding

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Procedure: remove the skull bone to drain the hematoma then replacing the skull plate in place.

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Traumatic Brain Injury Subdural Hematoma

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Traumatic Brain Injury Subdural Hematoma

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A subdural hematoma is a type of intracranial hemorrhage between the dural and arachnoid membrane spaces following the rupture of bridging veins, leading to increased intracranial pressure ICP in the surrounding brain tissue