Concluded Case

65 yrs male brought to ER with unresponsiveness state. GCS e1v1m3. pupils bl/ns/sr. interpret the image and management?

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Concluded answer

Cva : ICH WITH VENTRICULAR SPREAD (score:4-5) Right side. Manage with antiemetic anti epileptic and iv mannitol Grave prognosis to be explained to the patient’s relatives.

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Rt gangliocapsulo ventricular bleed with involvement of adjacent frontotemporal white matter,blood in the ventricular system including 4th ventricle with mid line shift,uncal herniation to left with midline shift to left with hydrocephalus. Major ICH ,prognosis is poor. REF to Neurosurgeon for documentation

Massive intracerebral hemorrhage Rt parietofrontal area seapage in ventricle Midline shift There is leakage in lt ventricle in post horn Poor gcs prognosis is crtitical

Thanx dr Dinesh Gupta
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Rt putamino capsule bleed with perforation to ventricular system including 4th ventricle,extension of blood in the frontotemporal white matter and rt parietal area. There is midline shift to left with hydrocephalus.Start antiepileptic, refer to neurosurgeon

Large right parietal bleed with ventricular breakthrough with mid line shift with obstructive hydrocephalus

Right parieto occipital hemorrhage with intraventricular seepage, and midline shift to left . Hydrocephalus+

It's rt sided ICH, control BP maintain on neuro line,Reffer to neurosurgeon

Cva : ICH WITH VENTRICULAR SPREAD (score:4-5) Right side. Manage with antiemetic anti epileptic and iv mannitol Grave prognosis to be explained to the patient’s relatives.

Obstructive hydrocephalus Right parieto occipital Hemorrhage ICH Opinion neurosurgeon

Right intracerebral haemorrhage might be due to hypertension. And IVH extension with significant midline shift. Decompressive craniectomy needed.

MASSIVE RT .CEREBRAL HGE RX PROP UP AT 45 ° .. .. O2 INHALATION . CARE OF PRESSURE AREAS CHANGE OF POSTURE SIDE TO SIDE MOUTH & THROAT TO CLEAR OF. .....SECRETIONS INDEWELLING CATHETER / CONDOME DRAINAGE . RYLES TUBE .... ...GLYCEROL PO ANTIBIOTIC PPI IV .. ...CCB

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