44yrs/M admitted today morning,ground level fall on Ventilator support,Pupils - B/l 7mm NRTL,Plantars - B/l mute.BP - 190/100,PR -52.Neurosurgeon explained poor Prognosis after seeing CT brain.APPROACH?
Rt Caudato putaminocapsular bleed with extension to rt tempirallibe There is uncal herniation with perforation if blood to lateral,3rd and 4th ventricle.Brain edema with compression if rt lateral ventricle and effacement of sulci and gyri Left lateral ventricle is mildly dialated .pupils 7 mm ,ie widly dialated. Prognosis is extremely poor. Needs supportive care.
Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!
Rt bg bleed with ivh with accelerated htn, do all blood workup , rule out associated co morbidity, what about the motor movement, if there is m1 ,nothing can be. Done , if better motor movement present evacuation of hematoma to be done , after negative covid test as today scenerio , poor prognosis .
Right parenchymal hemorrhage with brain stem compression along with intraventricular extension+ durate hemorrhage Looks like hypertensive bleed Pupils 7mm NTRL Fatal battle General supportive treatment POOR PROGNOSIS. IF relatives are willing then do it counselling for organ donation
Massive right sided cerebral hemorrhage with midline shift, extending into 3rd and 4 th ventricles. Management is to control the blood pressure, raised ICP, ventilatory support, electrolytes, input/output, Gastric stress ulcer prophylaxis, DVT prophylaxis, prevention of decubitus ulcer and nutrition. Neurosurgery consultation for possible intervention. Prognosis is guarded.
Large right parietal bleed with ventricular breakthrough with mid line shift
Seems patient is beyond help
Rt gangliocapsular bleed with intraventricular extension with midline shift . patient needs surgical evacuation with evd placement at the earliest by competent neurosurgeon ASAP
subarchod hoorhge ha
Cases that would interest you
- Login to View the image
55yrs old female patient presented to casualty in unconscious condition with H/o fainting after dizziness today. K/c/o HTN and DM since 3yrs not on regular treatment. O/e - Pupils - B/l Normal size sluggish reactive,GCS - E2V2M5,Bp - 180/90mmhg,Pr - 80/mt ,Spo2 - 95%,RR - 22/mt.Diagnosis with approach???
Dr. Prashant Ved8 Likes29 Answers - Login to View the image
A 36 yr old male suffering from rt sided hemiplegia 2 days ago, accelerated htn, family h/o htn , treated with inj. labetolol, and discharged at request due to economic reasons, now on tab. labetolol, eptoin, adv follow up, , ct scan and reports attached
Dr. Nayeemuddin Mohammed7 Likes21 Answers - Login to View the image
A middle aged woman 45 yrs age presented with complaints of Sudden onset Altered Sensorium, Inability to move left hlf of body and constant looking towards right side since 1 day...There was no h/o any comorbidity or drug intake.....Comment on the approach to this pt...
Dr. Hardik Ahuja5 Likes20 Answers - Login to View the image
70 yrs male h/o sudden falled on ground 1 day back while walking, followed by weakness of lt upper and lower limbs bp was 260/120 pr 100/mt conscious after m20%,epsolin,lasix, antibiotics,methylcobalamin,neurocetam, aspirin,rosuavas,depin now well please suggest ur valuable opinions
Dr. Satish Kumar2 Likes19 Answers - Login to View the image
38yrs old brought to casualty with complaints of alleged H/o sudden LOC while standing in ground. No comorbidies,H/o Headache x 7days O/e GCS - unconscious,Pupils - B/l 4mm RTL Right sided hemiplegia with power 0/5 GCS - E1V2M4-5,BP - 170/80mmhg,HR - 90/Mt,Spo2 - 100%
Dr. Prashant Ved3 Likes21 Answers