10 years old female patient presented by sudden disturbed level of consciousness.O/e - flexion to pain, eye opening to pain,no sounds. history of headache for 2 month and one attack of fits . DIAGNOSIS AND MANAGEMENT PLAN?
Primary intraventricular hemorrhage into lateral a d 3rd ventricle with obstructive hydrocephalus- cause could be Aneurysmal bleed AV - malformation bleed Choroid plexus tumor with bleed . Treatment- includes get a MRI scan of head and prepare for ventricle- peritoneal shunt
NCCT demonstrate a heterogeneous,suprasellar,mixed cystic and solid hyperdense mass with ?calcification with dialatation of both lateral ventricles suggestive of hydrocephalus. Very difficult to say bleed or calcified lesion. DD Craniopharyngioma Germinoma Partially thrombosis aneurysm
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It's bleed in hypothamic area with ventricular extension.. do angiogram venogram ..Vein of Galen malformation likely in this area..also urgent ventriculostomy essential to save child
Signs of pontine bleed @Dr. Prashant Ved with early hydrocephalus need urgent evacuation and nsx opinion... But try to find out the cause of the bleed at this early age
ventricular hemorrhage with hydrocephalus
I C Bleed ? tumour bleed ? spontaneous bleed with gross hydrocephalus straight go for EVD / VP shunt start Anticoagulant Anti epileptic conservative treatment and tab Diamox via RT then go for MRI Brain find out the cause for bleed
Upper brain stem bleed? Brain stem SOL. Conservation as of now with gad MRI.
Is there a shunt in situ?
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