Robert Rose, a 45-year-old taxi cab driver, is brought into…
Robert Rose, a 45-year-old taxi cab driver, is brought into the Emergency Department via helicopter following a motor vehicle crash where he was an unrestrained driver. He was ejected from his vehicle after he lost control and hit a large tree. A passing motorist witnessed the crash and called 911. Emergency personnel arrived within 5 minutes. Mr. Rose was found lying on the ground disoriented and combative with a GCS of 14. His medical history is unremarkable. As the EMTs were trying to calm him, he suddenly lost consciousness. His left pupil was 4 mm with sluggish reactivity. His right pupil was 3 mm and briskly reactive. His GCS was now 7. He was intubated and transported to the ED. On arrival to the ED, he suffered a seizure. His pupils were still unequal, with right being 4 mm and left 6 mm and both sluggish to light. His BP was 135/80. He was in sinus rhythm with a HR of 60. Given the above assessments, what injury are you most concerned Mr Rose has sustained?
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