Assault with Head Injury
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A 54-year-old male with a history of alcohol use disorder and GERD presents with acute intoxication, altered mental status, abdominal pain, and periorbital ecchymosis following a reported assault. He is a poor historian. CT head reveals bilateral acute intraparenchymal hemorrhage (right temporoparietal and left frontal/temporal lobes), small bilateral subdural hemorrhages, right-to-left midline shift, and advanced cervical degenerative changes without acute fracture. Trauma surgery consulted; patient's only reported complaint is headache.