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???



A hypertensive large intracerebral haemorrhage in the region of left basal ganglia region with compression of left lateral ventricle with midline shift and cerebral edema. Maintain air way and give ventilatory support for few days . Control of hypertension with labetalol. Decongestive therapy with Inj mannitol, injection Eptoin, inj pantoprazole, control of DM with insulin Catheterisation, supportive care, input output chart

Left sided Intracerebral bleed with intraventricular extension and midline shift...poor prognosis....but proceed as always ...reduce the ICP ..maintain BP around 140/90....dont use Vasodilators....Neurosurgery review for hematoma evacuation if possible

Left Thalamic bleed ? hypertensive bleed Maintain airway Anticonvulsants IV Mannitol 100ml every 6th hrly BP control (Inj.Labetelol) Blood sugar control Supportive management Neuro surgical opinion ABG SOS ET Intubation and mechanical ventilation

Left side IC bleed. Maintain Airway, breathing, circulation. Strict BP control. Systolic BP less than 140mm of Hg. Continue Anti-oedema measures like Inj Mannitol, 3% NS. Good nutrition, back care, bladder and bowel care, dvt stockings. SOS intubate and initially hyperventilate. And Neurosurgeon opinion.

Left thalamo-capsular bleed withuncal herniation withcompression of 3rd ventri le and posterior horn of lt lateral ventricle

Prognosis seems to be poor.Needs all supportive management @

Acute haemorrhage in left thalamus with Intraventricular rupture.

Agreed with @Dr. Sushant Yadav

Thank You Sir

ICH left side.

Intracranial Hge with left ventricular extension. Initially ventilator support on CMV mode. Mannitol, Anticonvulsants, Antihypertensives Symptomatic, Supportive treatment. Catheterization ABG, sugar control, RT feeding, temperature control, posture change will be there If Hydrocephalous develops.. EVD

Left sided ICH Inj Mannitol 20% 100 cc Iv stat Start her with antiepileptics Maintain ABC CT head on 3rd day Controll her HTN

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