Doin’ the tack shed blues

You are perturbed by the mechanism and clinical findings, so request an X-ray of his facial bones.

What does this show? (1 mark)

You re-review him happily playing on his Nintendo Switch and chatting with his Dad. You are still concerned, given the mechanism and the clinical/x-ray findings.

What is the next management step. (1 mark)

You admit him to your paediatric observation ward for neurological observations overnight. He remains stable. The next morning he eats his Weetabix, but on mobilising he vomits. He then vomits again.

What is the main finding on the CT scan and what feature of this finding is suggestive for ongoing bleeding? (1 mark)