Concluded Case

Tramatic Brain injury with diffuse SAH ,Multiple hemorrhagic contusion

67 yr ,F ,she felt dizzy and fell down on 5th october while working in the kitchen.No head ache,no vomiting ,no motor or sensory symptoms. With the help she got up ,vomited once. Evaluated locally diagnosed to have hypoglycemia Known Diabetic on oral med . Since 2 yrs she has progressive hearing loss ,evaluated before on a few occassions. Examination- Vitals stable,BP 140/ 80 mmhg . Normal higher functions and optic fundi. Intact ocular movements with gaze evoked nystagmus more prominent on the left side.5th 7th cranial nerves normal Sensory neural deafness left side.Normal other cranial nerves. Motor system gr 5/ 5 power DTRS equal bilaterally. Mild random walking abnormality ,tendency to sway to left.Alreadt ref the case to the Neurosurgeon. Surgery is fixed for 13th oct. What abnormality in the MRI? What is the diagnosis?.

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Concluded answer

Thanks for the answeres. End of physical exam ,another pts findings also mixed . I do not know how it happend.I am sorry for the same. This is a case of extensive SAH with hemorrhagic contusion in the rt mid- brain extending to pons and rt superior cerebellar peduncle . Dependent hyperdensity in the occipital horn of both lateral ventricles. Undisplaced # anterior 1/ 3red of rt squamous bone. pt is under neurosurgeon.Was on ventilator. Tracheostomy done. Stable ,Out from Neurosurgery ICU.

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Thanks for the answeres. End of physical exam ,another pts findings also mixed . I do not know how it happend.I am sorry for the same. This is a case of extensive SAH with hemorrhagic contusion in the rt mid- brain extending to pons and rt superior cerebellar peduncle . Dependent hyperdensity in the occipital horn of both lateral ventricles. Undisplaced # anterior 1/ 3red of rt squamous bone. pt is under neurosurgeon.Was on ventilator. Tracheostomy done. Stable ,Out from Neurosurgery ICU.

Diffuse areas of hemmorrhage...b/l SAH with IVH...with HCP ...with diffuse edema.. Currently conservative management advise...later EVD can be planned if HCP raises..

Pontin and cerebral bleed with ventricular and subarachnpid hemorrhages

Seems multiple area hemorrhage Brainstem with cerebellar peduncle , b/l frontal, SAH with IVH Possibility of arteriolar hyelinosis f/b hemorrhage can be there !!

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