Young male Patient - Emergency Check Up -End 2020- DAY O

• victim of a serious cranial trauma during while doing sport in 2020.

• The Head Trauma Score is 1-15 on the Glasgow Scale
  

• isocoria of the 2 pupils

• Right Facial Paralysis
• Absence of Motor Sensory Deficit
• An early craniocerebral computed tomography ( < 1h) was performed.

• Right fronto parieto occipital fracture lines passing through the petrous bone with depression of a bone fragment estimated at 6 mm.

• Cervical Spine : Nothing to repor

• parietal hemorrhagic contusion next to a non-compressive extradural hematoma 15 mm thick without mass effect on the cerebral parenchyma and median structures.

• hematic filling of the prepontic cistern on the right as well as in the right latero cerebella.

• right extra dural hematoma in the process of organization on a background of clinical improvement

• Clinical Improvement with conscious patient, absence of motor sensory deficit, reactive isochoric pupils, facial paralysis on the right.

• ENG with recording of the nasalis muscle: absence of motor response
• study of the reflex right blink: small reflex response R1 of elongated latency on the ipsilateral side
• EMG at the level of the right frontal muscle: signs of almost total denervation without signs of reinnervation.
• EMG at the level of the orbicularis muscle of the eyelids: signs of almost total denervation without signs of reinnervation
• EMG at the level of the right chin muscle: signs of reinnervation