"Good lord! Look at the size of those ventricles."

At 10 minutes to 9 am I was feeding Tyler breakfast and eating myself. When I reach over to get his cereal box and hear Thump!, Waaaaaa! Tyler had kicked the kitchen table so hard that his high-char fell over. He took a pretty hard bump on the head. He cried right away (a good sign). He had his 6-month eye follow-up yesterday so we had a hard time telling if his slow pupil reaction was a result of being dilated for the exam or the whack on his head. So off to the ED we go.

After the fall tyler is overall acting just fine. Walking, talking, hungry not vomiting. The only real concern we had was the bug hit to his head and the slow response of his pupils to light.

On the way to the ED Sharron and I were going over the standard medical history speech. We had to laugh when we realized that we both put pauses in about the same places so that the audience has moments to absorb, react or ask us to define acronyms. You know that you have a complex case when it takes 15 minutes to refresh yourself on the whole spiel.

Things in the ED go as we would expect. The ED was slow, so they jumped us right over triage into a bed. After 20 minutes of the Tyler medical history show the Dr came in and decided to order a head CT. While waiting for the results of the CT we hear that same doctor make some exclamation about large ventricles. When he came in to go over the results he stated carefully explaining that his ventricles were larger than normal, and that it may be "normal" for him with his history. It should be noted that this was the first head imaging that SNHMC has done on him so they had no point of reference. So we did what we always do, asked to see the films. Apparently "normal" parent's aren't interested in seeing diagnostic images of their child's head injuries. When we see them we both blurted out that we thought his ventricles looked smaller than our last appointment with neurosurgery. This was enough to make the ED doc decide to call our friends in Neurosurgery. After some back and forth they decide to send us home.

About an hour after we get home Sharron gets a call. The ED doc decided to discharge us without clearing it with radiology. We were to report up to Lebanon and see Neurosurgery. Radiology didn't like something that they saw in the CT scan. So here we are. The ED here is so full we get the first quick exam in the waiting room. The Neurosurgery crew compared the images we brought up with us. It appears that there was something that needs a closer look.

The bright white bullet shaped object is part of the tube of his shunt the white circle is bone, the light grey is brain and the dark grey is ventricle fluid. The area of concern is the small light shadow next to his skull just to the left of the shunt tube. It could be new today, or just new since his last MRI. Based on the color the docs suspect that it is most likely blood.

They are going to keep him here overnight for observation and a quick MRI in the morning to make sure everything is good to go.