A 56 yr old female presented with complaints of Sudden onset Altered sensorium and Respiratory distress since 5 hrs...Got intubated in some private setup and arrived with very poor GC of E1VtM3....Discuss the site of lesion and treatment that could save her life...



Brain stem bleed Ventilatory support Anticonvulsants IV Mannitol BP control Patient will need a prolonged ventilation/airway protection consider early tracheotomy Neurosurgery opinion Close neuro monitoring

Blood in yhe body of lateral ventriclr , 3rd ventricle, 4th ventricle, brain stem& lt cerebellum with early hydrocephalus Rt ct 12 hrs . Neurosurgical consultation urgent.

Cerebellar + brain stem bleed, + Intraventricular extension , Urgent Neurosurgical decompression was needed.

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Brain stem bleed with obstructive hydrocephalus Cerebral decongestant, neurosurgery opinion for EVD , poor prognosis

?Hypertensive brain stem bleed in Mid brain n pons.Needs neurosurgical consult.Explained prognosis Treat conservatively.

Hyponatremia,intracerebral bleed:electrolyte correction, antiedema, anti convulsant measures,airway, O2 saturation, nutrition support:neurosurgery consultatation

Sudden massive raise in icp is suspected. A pontine bleed or any brain stem haemorrhage can be possible. Sudden hydrocephalus or even an aneurysm bleed can lead to this.  Stabilise the patient. Get a Cat brain and rule out hydrocephalus. If present, put an evd post haste to reduce icp and drain csf in a regulated manner. Once the patient is stable, get an mri to look for other aetiology. And angiogram maybe indicated for aneurysms. Proceed accordingly. Don’t rule out sepsis or meningitis if indicated historically. The prognosis is poor

Brain stem Bleed Needs Neurosurgeon Intervention

Needs a neurosurgeon opinion on this case , bleeding seen on intracranial range...

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