34 y male Fall from stairs around 3 hrs back On arrival GCS 3/15 - intubated No abrasions / No lacerations / No external Injuries - maintaining all vitals after intubation - Further management ?



Ventricular haemorrhage. S -3/15 .Poor prognosis. Ventilatory support. External ventricular drain or ventriculostomy is advised to reduce intra cranial pressure. ICU care

Intraventricular bleed Assessment Glasgow Coma score.. If less than 5 prognosis poor. Neurosurgical opinion..

Case of IVH ..poor prognosis..ventilation & icu care continued with haemodynamic support ..prevent secondary injury ..neurosurgery opinion & go for ventriculostomy & maintain icp

Monitor vitals continuosly Prevent secondary brain injury due to ischemia, hypo/hyperglycemia Maintenance of HD stability If on anti coagulation.. Ffp Urgent neurosurgery consult and plan for external ventricular drain sir

Very poor prognosis in view of brain stem hematoma Insert EVD... Approximate height of fall?? As pattern of bleed doesn't look like traumatic... If patient improves needs to rule out AVM..

It's a case of intraventricular bleed.

@well i can't interpret ct. Scan.is he mobile all his four limbs working , is he conscious. I that case wait and watch. Otherwise tell signs and symptoms.

Sir, please read the case stem, it already says GCS to be 3/15 on arrival. That's the least possible score.

Immediate EVD first


Take opinion of neurosurgeon

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