Concluded Case

opine what

50years female presented with gcs3/15..hypertensive. Intubated kept on ventilator. Bad prognosis explained. Past history admited some wherewith hemiparesis. Commen on ct&management

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Concluded answer

thank you all for nice response. ita case of 5days old infarct suddenly turning haemorhagic. as gcs is 3/15 at the time of admission in our hospital inspite of all resuscitation measures patient expired..this scan is on 5th day&1st scan was not available.

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A large hypertensive haemorrhage in the left temporo- parietal region with perilesional significant oedema , gross and significant mid line shift to right side ,, compression of left lateral ventricle and uncal herniation Probably due to rupture of a berry aneurysm A poor prognosis. Management remains conservative with decongestive therapy with mannitol, ventilatory support, AED'S , IV fluids and supportive treatment. Neurosurgical intervention should not be attempted in such situation

Thank you doctor
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Left temporal lobar hematoma with blood in the left sylvian fissure. There is perilesional edema,compression of left lateral ventricle with midline shift. Already intubated. What is the current BP and how much was the BP at the time of admission?. In view of the blood in the sylvian fissure and temporal lobe ,needs angiogram to exclude LT MCA aneurysm

Thank you doctor
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Mid line shift to rt Lt ventricles are opaque due leakage 9f hemorrhage which is fresh and massive in lt parietal and subtentia nigra Cerebral oedema is noted Definitely a very poor GCS and prognosis It looks to be acute on old infarct Rx monitor vitals Gradual control of bp as pt is hypertensive Iv inj Ceftriaxozone Inj dexamethasone Inj lasix Consider inj clexan if inr in control Maintain ventilation

Thanx dr Praveen Yograj sir
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thank you all for nice response. ita case of 5days old infarct suddenly turning haemorhagic. as gcs is 3/15 at the time of admission in our hospital inspite of all resuscitation measures patient expired..this scan is on 5th day&1st scan was not available.

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