A 21yrs old male present to casualty in unconscious state.Intubated putted on ventilator support.complaint of fever for 5 days. O/e - CNS - Deeply unconscious,Neck rigidity negative Pupils - B/l dilated fixed GCS - E1VTM1 BP - 120/80mmhg BSR - 290mg/dl,maculopapular rash all over body.Need opinion?

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Left sided intracranial hemorrhage. Associated midline shift. With diabetes. With thrombocytopenia with raised enzymes with anemia? Malaria . Suggest MP , and other causes of thrombocytopenia including dengue. Antiedema measures. Anti epilepsy medicine. Look for cause. The pupil are dilated and can't be decompressed with thrombocytopenia. So overall guarded prognosis.

Thank you sir.
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A large left sided intracerebral haematoma with gross midline shift and compression of left lateral ventricle. Head injury to be ruled out. DM with cerebral malaria? Intracranial bleed can be part of thrombocytopenia associated with Dengue fever

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