June 18 - Day 4

Saturday the 16th the hospital performed a second CT scan of Dean's head to determine how things were progressing, but we did not receive a report until nearly 8:00 that evening. At this point they told us that a blood clot had begun forming toward the front of his skull and that if it expanded and added to his brain pressure, they would need to operate to remove it. They scheduled another CT for 5:00 a.m. Sunday morning. We received the results of this one much more quickly: the blood clot had accumulated at the front of his skull and had not increased in size and his body seemed to be dealing with it naturally.

After this, they began planning a tracheotomy for Dean as the first in a series of steps toward reconstructing his facial bones. This is earlier than they would normally need to trach a patient, but because of the multitude of fractures they wanted to get the tubes out of his mouth so that they would be ready to begin work on the face as soon as the brain swelling went down enough. This morning they took him to the OR to perform that surgery and it went fine except that he reacted to the added stress and his ICP (intra-cranial pressure) rose again.

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