Reference no: EM133333422

Case Study: 16-Year-Old Male with a History of Substance Abuse, Learning Disability, and Closed Head Injury HISTORY: The patient is a 16-year-old, right-handed male with a history of substance abuse including alcohol, cocaine, crack (cocaine), heroin, and "angel dust" and a severe learning disability for which he had been receiving special education services. He was admitted to the ER by ambulance after falling off the back of a moving pick-up truck. On examination, his pupils were fixed and dilated and he was nonresponsive. Emergency CT scan showed a depressed right temporo-parietal skull fracture and an epidural hematoma with a moderate degree of mass effect and shift from right to left. A craniotomy was performed and the hematoma was successfully evacuated. The patient, however, remained in a comatose, but medically stable state for seven weeks. An EEG obtained during that period showed moderate bi-hemispheric slowing. He was independently breathing, not requiring ventilation. Repeat CT scan showed areas of mixed attenuation within the left frontal lobe at the level of the lateral ventricles; this study was otherwise normal. On awakening from coma, the patient was placed on phenytoin sodium (Dilantin) for seizure prophylaxis and discharged to the head injury unit. Multidisciplinary evaluations

Question: Where did the coup and contrecoup injury occur and what symptoms come along with this?