TY - JOUR T1 - Traumatic subdural haematoma: integrating case-based clinical judgement with guidelines JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-233197 VL - 13 IS - 9 SP - e233197 AU - Aditya Samitinjay AU - Satya Revanth Karri AU - Praveen Khairkar AU - Rakesh Biswas Y1 - 2020/09/01 UR - http://casereports.bmj.com/content/13/9/e233197.abstract N2 - Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity with a significant loss of functional capacity and a huge socioeconomic burden. Road traffic accidents are the most common (60%) cause followed by falls and violence in India and worldwide. This case discusses the story of a 23-year-old man with severe TBI–subdural haematoma, who presented in a comatose state. The patient was a purported candidate for emergency decompressive surgery as per Brain Trauma Foundation (BTF) guidelines but was managed conservatively. This case questions the plausibility of the BTF guidelines for severe TBI, particularly in rural hospitals in India and how such cases are often managed with clinical judgement based on the review of literature. The patient recovered well with a perfect 8/8 on Glasgow Outcome Scale Extended Score. ER -