Concluded Case

SEIZURES IN A 32YRS OLD FEMALE

32yrs/F G1P1 arrives to emergency unresponsive with shallow respirations.Patient is intubated on arrival to emergency.She had H/o NVD 15days back following which she had GTCS(3 episodes).Seizure lasted approximately two minutes followed by a ten minute of post ictal phase. O/e - Left sided hemiplegia present,BP - 180/90,PR -110,Pupils - B/l 4mm RTL,GCS - E1M3V1. Present status - Weaned off from ventilator support, Conscious,Aphasic,vitals unremarkable.Negative for Covid 19.DIAGNOSIS AND SUGGEST MANAGEMENT PLAN?

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Concluded answer
There IS SAH in CT scan. IC bleed is a rare presentation during pregnancy and peuperium. Most common cause being Aneurysm, AVM, sinus thrombosis. In this patient anticonvulsant and antiedema to be continued. DSA and coagulopathy to be seen. Pregnancy is a hyperdynamic and hypercoagulable state.
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There IS SAH in CT scan. IC bleed is a rare presentation during pregnancy and peuperium. Most common cause being Aneurysm, AVM, sinus thrombosis. In this patient anticonvulsant and antiedema to be continued. DSA and coagulopathy to be seen. Pregnancy is a hyperdynamic and hypercoagulable state.
Ct brain shows sulcal blood rt frontoparietal, hyperdense SSS, blood in the interhemispheric parasagittal area. Suggest DSA / CTA including venogram. Start antiepileptic ,further management after the CTA/ venogram
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Postpartum (Puriperal) superior saggital venous sinuous thrombosis with bleeding around Rt posterior frontal region and obliteration of sulci .
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Postpartum (puriperal) superior saggital venous sinuous thrombosis with bleeding around Rt posterior frontal multiple haemorrhages.
Sir,Any use of LMWX or Clavix AS in this case.
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Sss thrombosis probably
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Cerebral hemmorhage

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