58yrs old male brought to emergency with alleged H/o C/o sudden onset of severe headache since yesterday afternoon f/b vomitting. K/c/o HTN with T2DM(on regular medication) No focal neurological deficit present at the time of presentation.O/e patient drowsy,arousable,Pupils - B/l 4mm RTL,GCS - E3V5M6,BP - 190/80mmhg,Blood investigations unremarkable. Interpret CT scan head with approach??"

(Edited)

2 Likes

LikeAnswersShare

Ventricular and periventricular infarct

2 options at hand Operate electively as its large bleed and its right frontal lobe so good functional outcome. Same time ventricle blood can be cleared and evd can be inserted. Otherwise closely observe for deterioration in gcs and operate if neurological condition worsens

Urgent surgical intervention before consciousness worsens...
0

Its impossible score to be V5 and M4,kindly revise GCS

Rt frontal bleed with IVE with midline shift IV mannitol Iv Lasix Tab Telma 40 od hs (RT) IV Phenytoin Do not try to drop bp excessively.

Rt frontal lobe hematoma with mass effect seen,need neurosurgeon opinion..

Rt frontal lobe intraparenchymal hypertensive haemorrhage with intraventricular extension and midline shift. Simultaneously.. Check & Maintain ABCDE and Vitals. Control BP ( Labetalol infusion), Antiepileptic, Antiemetics. Stop drug causing bleed. ABG -electrolytes,glucose, lactate, HB. CBC Clotting RFT LFT. Urgent Neurosurgeon's & Neurologist opinion for further intervention, evaluation and Rx.

Valuable opinion
0

View 1 other reply

Neurosurgical Opinion. Till then elective hyperventillation. Adjust diuretics acc to creatinine clearence. Avoid mannitol if deranged Renal function. Antiepilleptics to avoid seizure

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 frontal lobar hematoma with perforation to frontal horn of RT lateral ventricle, body of the lateral ventricle ,posterior horn of rt lat ventricle 3rd ventricle & blood in te 4th ventricle with hydrocephalus & midline shift.Flm 5shows blood in body & frontal horn of left lateral vebtricle also.film 5, 6 & 7 shows some hypodensity in the rt MCA distribution. Artifact vs MCA infarction. Urgent Neurosurgical consult.

Valuable opinion
0

Rt frontal lobe haemorrhage with intraventricular extension and mass effect

Valuable opinion
0

View 1 other reply

Load more answers

Cases that would interest you