13 ### Trauma
MZ 14 Mild Head Injury (GCS 14) + Closed Conservative (NC) Kana Ward
linear fracture at left frontal + SBF
at anterior and left middle fossa
4 Severe Head Injury (GCS 4) + Shock Plan to skull, cervical, Passed Away
hemorrhagic grade IV no respons and thorac X-Ray if
transportable
14 Mild Head Injury (GCS 14) + Alcohol Refused for Skull, Refused
intoxication cervical, and thorac x-ray Medical
Advice
AD 15 ICH Spontan at Parietal Dextra e.c. Kraniotomi evakuasi per Kemuning Lt.
Hipertensi + P2A0 partus endoskopik 3
prematurus per histerotomi a.i. Bila GCS turun →
Eclampsia Kraniotomi evakuasi
CITO
RD 15 Spinal Cord Injury Francle E due to In Line position → TLSO Kana Ward
burst fracture at Level vertebra brace
Lumbar 1
MZ 15 Mild Head Injury (GCS 15) Conservative (obs GCS, EMG Ward
vital sign)
RD 15 Spinal Cord Injury incomplete Plan to ThoracoLumbal R.19
lession Frankle B ec. Susp. MRI
Traumatic HNP at level C5-6 + Plan to Laminoplasty +
Multiple HNP at level C3-4,C4-5, discectomy
C7-Th1, Th1-2 + susp. Spinal Cord
Injury Francle B in complete lession
at thoracal 12
MZ 15 Mild Head Injury (GCS 15) + Bone Debridement and suture EMG
avulsion at right parietooccipital + in OR (NC)
traumatic amputation at left 4th Plan to wiring
finger + open fracture of right (orthopedic)
olecranon
MZ 15 Mild Head Injury (GCS 15) Conservative (obs GCS, Sent home
vital sign)
MZ 12 Moderate HI (GCS 12) + cerebral Closed observation (NC) IHC Ward
contusion at right frontal and left Plan to ORIF elective
parietal + closed linear fracture at (Orthopedic) → Refused
right temporoparietal + closed Serial BGA and Chest x-
fracture of left clavicle and left ray (Thorax surgery)
scapulae + left lung contusion + Leader
closed fracture left costae 3-8
posterior aspect
MZ 11 Moderate HI (GCS 11) + EDH at left Craniotomy evacuation Kemuning 2nd
frontal + pneumocephalus at left (NC) ward
frontal + closed linear fracture at Casting (Orthopedic)
left frontal + SBF at anterior fossa +
closed fracture right distal end
radius
MZ 10x Mild Head Injury (GCS 10x) + closed Conservative Kemuning 2nd
linear fracture at right frontal ward
MZ 14 Mild Head Injury (GCS 14) + closed Conservative (Obs GCS, Kana Ward
diastasis fracture at left vital sign)
lambdoidea suture
MZ 14 Mild Head Injury (GCS 14) + closed Conservative (Obs GCS, Kana Ward
fracture linear at right temporal vital sign)
MZ 15 Mild Head Injury (GCS 15) Conservative (Obs GCS, EMG Ward
vital sign)
MZ 15 Mild Head Injury (GCS 15) Conservative (Obs GCS, EMG Ward
vital sign)
RS 15 Wound dehiscence at right frontal Local debridement Kemuning 2nd
+ Post Craniotomy tumor removal ward
due to SOL supratentorial at right
frontoparietal due to convexity
meningioma
MZ 15 Bone Defect ar left temporoparietal Plan to Cranioplasty RBA Ward
due to Post Craniectomy
Decompression due to Moderate
Head Injury (GCS 12) + linear
fracture at left temporoparietal +
SDH at left temporoparietal + SDH
left cerebellar + cerebral contusion
at left temporoparietal + SAH +
closed fracture right clavicle 1/3
middle
MZ 14 Mild Head Injury (GCS 14) + Skull Conservative (obs GCS, RBA Ward
Base fracture at anterior fossa + vital sign)
closed linear fracture at right
frontoparietal
MZ 15 Mild Head Injury (GCS 15) + closed Conservative (obs GCS, SW Ward
fracture linear at right frontal vital sign)
MZ 15 Mild Head Injury (GCS 15) Conservative (obs GCS, Sent Home
vital sign)
MZ 15 Mild Head Injury (GCS 15) Conservative (obs GCS, Sent Home
vital sign)
RD 15 Myelopathy due to multiple SOL Plan to Laminectomy RIK Ward
intadural extramedullary at level Tumor Removal (304)
C3-7, level T4-7, et level T12-L3 ec
susp. Neurofibromatosis type II
DD/ Scahwannoma, metastase
MZ 14 Mild Head Injury (GCS 14) + closed Conservative (NC) RBA Ward
linear fracture at left frontal + Plan to IDW (Oral
open fracture of right mandible surgery)
15 Mild Head Injury (GCS 15) + closed Conservative (NC) Sent Home
fracture of left clavicle 1/3 middle Conservative
(Orthopedic)
RS 15 Chronic SDH at right and left Burr hole drainage RGB Ward
frontoparietal
FM 12 Suspect serous meningitis + Lung Conservative EMG
TB + AKI + hyperkalemia
MS 15 Keloid + Post anterior resection due Plan to reconstruction Kemuning 2nd
to ME Nasoorbita + Schizencephaly floor
+ Dacriosistitis ODS
FM 15 Bone Defek a.r Bifrontal dan Sinus Debridement + Tutup Kemuning Lt2
Frontalis + post op mucocele at. Defek
Sinus frontalis ec massa retrobulber
MZ 15
NC : Konservatif
Mild Head Injury (GCS = 15) + SBF
(Observasi GCS, TNSR)
fossa anterior + # maksila + # B. Plastik : Barthon sling Kemuning 2
angulus mandibula sn
→ ORIF
MZ 15
Mild Head Injury (GCS = 15) +
Observasi (GCS, TNSR) Kana
closed # linear a/r frontoparietal dx
DSA
AD 15 Traumatik carotid cavernous fistula Kemuning Lt2
Embolisasi (Radiologi)
MS 11 Hidrocephalus akut non komunikan MRI (NC) A1
e.c SOL infratentorial e.c. suspek Perbaikan keadaan
brain stem glioma DD/ Cavernoma umum (IKA)
Rencana VP Shunt (SIO-)
MZ 13 Moderate Head Injury (GCS 13) + Closed observation (NC) Kemuning 2nd
fracture of left mandible and left ORIF elective (Plastic ward
maxilla Surgery)
MZ 15 Mild Head Injury (GCS 15) + Skull Conservative (Obs GCS, Kemuning 2nd
Base fracture at right middle fossa vital sign) floor
MZ 14 Mild Head Injury (GCS 14) + ICH at. Conservative (NC) RBA
left parietal
MZ 15 Mild Head Injury (GCS 15) + Skull Conservative (NC) Kana Ward
base fracture Nasal repotition (Plastic
at. Anterior fossa + Fracture Surgery)
nasal
MZ 5T Severe HI (GCS 5T) + Closed Conservative (NC) NCCU
depressed fracture > 1 table at left
frontotemporoparietal and < 1
table at right parietal + Closed
linear fracture at left parietal + SDH
at right parietal and left
temporoparietal + Cerebral
contusion at left parietal + SAB +
Pneumocephalus + Alcohol
intoxication
MZ 15 / Mild Head Injury (GCS 15) + SBF Conservative (NC) Kana Ward
anterior + Multiple fracture at left Enucleation OS + repair
maxilla, left zygoma, left orbital rim margo OS
inferior aspect, ethmoid, left (Ophtalmology)
sphenoid wing et right orbital rim Primary suture (Plastic
medial aspect + Prolaps bulbi OS + Surgery)
Ruptur margo palpebra superior et
inferior OS + Abrasi cornea OD +
Ruptur canaliculi palpebra superior
et inferior OS
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