Concluded Case

Fisher grade 1V SAH with ICA cavernous segment aneurysm Lt

46 yr old ,female, Presented with abrupt onset of head ache and vomiting with out any comorbidities. EXAMINATION SHOWED NECK STIFFNESS ONLY. Chief Complaints On 27 th March while washing the cloth ,she suddenly felt severe head ache,and sat down in the floor. Vomited 3 times and was evaluated at local hospital,CT brain was done and ref to our hospital. The hospital notes , documented that she was confused on arrival and was restless. History No past history of any significant medical illness Denied having any family history of stroke or SAH. Vitals Afebrike . Bo 150/ 90 mmhg . Hr 80/ mt Physical Examination Tendency to sleep. On shaking and calling opening the eyes,moving all limbs ,answering coherently.( received Tramadol in the 1st hispital) Normal pupils . Intact cranial nerves. Motor system gr5/ 5 power DTrs equal. Plantars downgoing. Mild neck stiffness noted. Investigations Routein bloid work up including biochemistry- normal. CT BRAIN done. Diagnosis Hemorrhagic stroke. Details for discusdion Management Admitted under Neurosurgeon in the Neurosurgical ICU for further management.

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Concluded answer

* Diffuse thick SAH * Mild IVH in the occipital horn of both lateral ventricles * Modified Fischer grade 1V SAH. * Diffuse cerebral edema. * ICA cavernous segment aneurysm left . * No evidence for hydrocephalus.

All Answers

* Diffuse thick SAH * Mild IVH in the occipital horn of both lateral ventricles * Modified Fischer grade 1V SAH. * Diffuse cerebral edema. * ICA cavernous segment aneurysm left . * No evidence for hydrocephalus.

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