A pt is brought to the emergency as a case of head injury, following a head on collision road traffic accident. His BP is 90/60 mmHg. Tachycardia is present. Most likely diagnosis is:

Answer is D (Intraabdominal bleed) : Although extradural haemorrhage is the most common intracranial complication following head injury, the patient in question is suffering from severe hypotension of 90/60, & has tachycardia, which cannot be explained by extradural haemorrhage alone. A patient with head injury, more than often has other significant injuries and a thorough examination of other systems therefore is a prime necessassity. An intraabdominal source of bleed, like a ruptured spleen for example is a more likely cause for hypotension in this patient.