Concluded Case

Large Intraparenchymal Hematoma Lt Frontotemporoparietal Lobes

New case 67 yr ,M ,Hypertensive ,CKD ,on regular dialysis, last on 9th june ,noted decreased response on 9th june at 10PM ,7 hours after dialysis. On ER arrival unconcious BP 220/ 120 mmhg,deeply unconcious ,pupils 4mm rt 3 left ,both nonreacting. Intubated and ventilated at ER and admitted in the Neurosurgery ICU.Getting supportive med and ventilatory care. Diagnosis & prognosis ?

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Concluded answer
Thanks for the answeres. * A large hyperdense intraparenchymal hematoma involving left frontotemporoparietal lobes,centered at left basal ganglia with superior extension to centrum semiovale& inferior extension to temporal lobe with surrounding perilesional edema. * Intraventricular extension in bilateral lateral ventricles & 4th ventricle. *Subfalcian & defending teanstentorial herniation to rt . *Rotational displacement of brainstem to rt. * Diffuse hemispheric edema. Patient expired.
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Huge intracranial hemorrhage of hypertensive nature. Poor prognosis
Thanks for the answeres. * A large hyperdense intraparenchymal hematoma involving left frontotemporoparietal lobes,centered at left basal ganglia with superior extension to centrum semiovale& inferior extension to temporal lobe with surrounding perilesional edema. * Intraventricular extension in bilateral lateral ventricles & 4th ventricle. *Subfalcian & defending teanstentorial herniation to rt . *Rotational displacement of brainstem to rt. * Diffuse hemispheric edema. Patient expired.
Just ventilate and pray god
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