acute subdural haematoma, cause undetermined (could result from trauma, fall, seizure, or spontaneous bleeding)
AI-generated summary
Paul Thompson, aged 57, died from acute subdural haematoma (brain bleeding). He was found unresponsive after an evening of heavy alcohol consumption with his housemate Lawrence Kean, who punched him during an altercation over music volume. Kean delayed seeking emergency assistance for several hours after discovering Thompson unresponsive. The medical evidence identified four plausible causes: direct trauma from punches, fall-related head injury, seizure-induced collapse, or spontaneous bleeding. Thompson had multiple prior head injuries with residual scarring, post-traumatic epilepsy poorly controlled by medication, severe alcohol dependence, and high intoxication levels at death. The coroner could not determine causation beyond a reasonable doubt. Key clinical lesson: unresponsiveness with concerning features (gurgling) warrants immediate emergency assessment regardless of intoxication or initial apparent stability.
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