Concluded Case

HEMIPLEGIA, APHASIA AND UNCONSCIOUSNESS IN A 65YRS/F

65yrs/F suffered with an acute weakness on right side yesterday night, Unconscious,GCS E1M2Vet,pupils B/l semidilated fixed non reactive to light on ventilator support.She suffered this while she was working in the kitchen.HTN for 8yrs,Poorly controlled diabetes since 3months.Known CAD on Clavix AS 75.Poor prognosis explained.DIAGNOSIS AND MANAGEMENT PLAN?

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Hematoma left temporofrontocapsuloganglionic area with significant midline shift,uncal herniation to rt with seepage of blood to lateral and 4th ventricle and brainstem. Severe compression of lateral ventricles with global brain edema. There is small sulcal blood in the lt temporal andleft tentorium. Management - Supportice care. Prognosis poor. HEMIPLEGIA WITH UNCONCIOUS STATE. HOW CAN ONE MAKE OUT APHASIA???

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Hematoma left temporofrontocapsuloganglionic area with significant midline shift,uncal herniation to rt with seepage of blood to lateral and 4th ventricle and brainstem. Severe compression of lateral ventricles with global brain edema. There is small sulcal blood in the lt temporal andleft tentorium. Management - Supportice care. Prognosis poor. HEMIPLEGIA WITH UNCONCIOUS STATE. HOW CAN ONE MAKE OUT APHASIA???

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Acute I C H lt side in tempoparietal area and substentia nigra superior ventricle and midline shift to rt Cerebral oedema is noted Poor past medical history Keeping control on blood sugar and gradual control of bp Inj manitol Inj lasix Inj dexamethasone inj Ceftriaxozone Rest supportive treatment Very poor prognosis

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Acute bleed in lt temporal lobe Midline shift right Unconscious Intubate iv ns Opinion of neurosurgeon Stop antiplelet Admit

left ICH..quite bad bleed and GC..not worth chasing

There is mass effect d/t h'age.kindly refer to neurosurgeon for decompression

Intracranial Haematoma

Arnica

Poor prognosis Less chance of survival.

Immediate Neurosurgical referal .

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