Concluded Case

Hypertensive intraparenchymal hematoma Rt capsuloganglionic area.

46 yr,M , Preented with head ache followed by left sided weakness on 4th of this month after taking his lunch and on the way to washroom.Sudden onset of mild headache only with out any nausia / vomiting. Know hypertensive 6 yrs ,on amlodipine but missed 3 day amlo. Non smoker ,occ ethanol once in a month only last drink august 30th. On exam BP 170/ 100 mmhg ,fulyconcious,communicating well.Left sided hemiplegi with gr3/5 power with hyperreflexia left with extensor plantar. Current state,BP well under control,getting physio,supportive care .Motor Power started improving. What is the diagnosis?

4 Likes

LikeAnswersShare
Concluded answer

Thaks Curofy and all other doctors who answered the case. CT brain shows .Acute intra-perenchymal hematoma involving the Rt capsuloganglionic region extending in corona radiate,centrum semiocale and adjacent frontal deep white matter with intraventricular extension. * Mass effect in the firm of effacement of rt lateral ventricle. He received conservative nanagement, control of BP and physio. Improved and discharged home

All Answers

Right sided intracerebral hemorrhage. There's associated midline shift. Hypertensive location, possible aneurysmal bleed. GCS needs to be monitored. Decompressive Craniectomy may be needed. Angiography? Might be useful

Thank you doctor
0

typical bleed.. as such no indication for surgery, however, such borderline bleeds can be offered early endoscopic evacuation and have been observed to have better motor recovery

I agree
0

Mostly hypertensive ICH ....Rt frontal craniectomy and evacuation or Endoscopic surgery and evaluation of hematoma and watch for hydrocephalus...if it is then sos EVD insertion

Thaks Curofy and all other doctors who answered the case. CT brain shows .Acute intra-perenchymal hematoma involving the Rt capsuloganglionic region extending in corona radiate,centrum semiocale and adjacent frontal deep white matter with intraventricular extension. * Mass effect in the firm of effacement of rt lateral ventricle. He received conservative nanagement, control of BP and physio. Improved and discharged home

A large hypertensive intracerebral haemorrhage right temporal lobe with midline shift to left and compression of right lateral ventricle with perilesional cerebral oedema - most likely a berry aneurysmal rupture . Treatment mainly remains conservative. If condition deteriorates - a neuro - surgical consultation is indicated

Valuable opinion
0

Hyperdense lesion involving the Right Gangliocapsular segment with perilesional edema mass effect with compression of ipsilateral ventricle probably a Hypertensive bleed. R/o Vascular anamoly/Amyloid angiopathy Neurosurgical opinion for surgery

Thank you doctor
0

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!

ThanksCurofy
0

Rt sided thalamic stroke Shift of midline left Cerbral oedema Opinion of neurologist Lacunar infarct in lateral ventricle Follow up with mri

Midline shift to left Ischaemic stroke in rt thalamic & rt ventricle Follow up of with mri Opinion of neurologist Physiotherapy

Right capsuloganglionic bleed with perilesional edema with mass effect ,Hypertensive bleed

Valuable opinion
0
Load more answers

Cases that would interest you