Concluded Case

Cerebellar bleed causing early hydrocephalus

68yrs/M known Hypertensive on irregular treatment presented with Sudden onset of headache, vomitting and instability of gait. O/e - CNS - Semiconscious,disoriented,ataxia and scanning speech,Pupils - B/l 4mm RTL,GCS - E2V2M4-5,BP -190/100,PR -74,Spo2 - 98% on room air.APPROACH?

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Concluded answer
Rt. Cerebellar +intraventricular hemorrhage 4th and 3rd ventricle without much hydrocephalus. Hypertensive bleed Clinically cerebellar signs of ataxia + gait unsteady Management- Blood pressure control aggressive management with inj Labetalol bolus followed by infusion keep bp <140/80 Daily CSF drainage 30-40 ml till ventricles clear x 2- 3 days. Observation and wait for sx.
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A hypertensive intracranial bleeding involving the,right cerebellum., with intraventricular hemorrhage in the 3rd and 4th ventricle- but not yet significant hydrocephalus. Right now conservative treatment in ICU setting Management- Gradual lowering of B.P with labetalol in drip ., Oxygen support with mask and decongestive therapy and AED'S Only if hydrocephalus increases after a re- scan after 3 days - a neurosurgical consultation regarding IVD or evacuation of bleed is indicated
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Rt. Cerebellar +intraventricular hemorrhage 4th and 3rd ventricle without much hydrocephalus. Hypertensive bleed Clinically cerebellar signs of ataxia + gait unsteady Management- Blood pressure control aggressive management with inj Labetalol bolus followed by infusion keep bp <140/80 Daily CSF drainage 30-40 ml till ventricles clear x 2- 3 days. Observation and wait for sx.
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Cerebellar bleed obstructing the fourth ventricle, explained by poorly controlled hypertension... It generally carries decent prognosis if timely evacuation and control of hydrocephalus can be obtained. Take nsx opinion pls... Until then manage conservatively and symptomatically with BP management.
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Rt cerebellar bleed with perforation to4th,3rd and body of lateral ventricle with early hydrocephalus. Control BP, symptomatic med,rept ct brain 12 to 24 hrs dependingon the general condition to look for hydrocephalus status , if further enlargement ref to Neurosurgeon . Needs ICU observation.
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Consider putting an EVD. in such cases most detrimental is raised ICP.
Brain stem bleed ventricular extension Conservative treatment if increases or Hydrocephalus develops go for EVD
Acute right cerebellar bleed with ventricular breakthrough
Thanks sir. Approach??
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St cerebellar haemorrhage due to htm,coma
Thank you doctor
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Put evd, ventilate sos
Thank you doctor
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Post op CT
@Yashesh Dalal sir,@Bhupesh Kumar sir,@Parveen Yograj sir,@Dr. Gajanan Patil sir,@Anand Kumar sir
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