Sub Dural Hematoma

66 year old male had reported to OPD with complaints of slurred speech and headache from last one day Bp 160/90 RBS 99 mg/dl LDL C - 120 NON HDL - 160 His investigations are attached which are suggestive of SDH and old lacunar infarcts Kindly give your valuable opinion on this case

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Left subacute extensive subdural hematoma in frontal temporal and parietal region Patient is symptomatic with headache and slurring of speech There is mass effect causes by SDH All above finding may suggest that I've should opt for surgical evacuation of SDH But Subdural hematoma surgeries are often associated with complication These are recurrence of SDH in postoperative period, prolonged ventilator support, poor neurological recovery and neurological deterioration after surgery There one should be cautious in both situations, conservation as well as surgery

Hyperdense acute SDH left frontotemporoparieto- occipital maximum thickness temporoparietal convexity. There is mild compression of left lateral ventricle with effacement of sulci left Suggest suggest- Ref to Neurosurgeon for evacuation of SDH. HOLD ANTIPLATELETS IF THE PATIENT IS TAKING

SDH all along lt temeroparital to cerebellum Mid line shift Pt needs surgical intervention to release the compression and mid line shift Yes meanwhile to put on conservative line Inj ns Inj lasix inj dexamethasone 8hrly Inj Ceftriaxozone Keep vitals in control

craniectomy followed by evacuation of SDH anti edema antibiotics anti epileptic neurosurg opinion

plan for craniectomy followed by evacuation of SDH neurosurg opinion iv antibiotics anti edema

needs surgery

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