Intracerebral Haemorrhage - A Neurologic Emergency Well Managed

Intracerebral haemorrhages must always be referred to a specialist emergently. Timely intervention, be it medical or surgical, is crucial in preventing expansion of the haemorrhage and neurologic deterioration. Share your views on this clinical case of Basal Ganglia Intracerebral Haemorrhage by Dr. Prashant Vedwan. Follow us for more such updates!

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Congratulations and Thanks Dr Prashant Vedwan for a complete and elaborate presentation of this case of Basal ganglia intracerebral haemorrhage. The most important aspect is that- this was one of the rare cases of basal ganglia haemorrhage- where early neurosurgical intervention with in 3 hours of admission saved an important life Although generally conservative treatment is indicated in basal ganglia haemorrhage Intracerebral hemorrhage is a neurologic emergency that requires immediate neuroimaging to differentiate it from acute ischemic stroke. " Intracerebral hemorrhage in the basal ganglia is usually caused by hypertension. " Patients presenting within the first few hours have a high risk of hemorrhage expansion and neurologic deterioration. " Prognosis is based on multiple factors, including volume and location of hemorrhage, age, level of consciousness, presence of intraventricular hemorrhage, and warfarin use. " Coagulopathy, if present, should be corrected. " Rapid blood pressure control is safe but does not improve the clinical outcome significantly. " Clinical trials have failed to prove benefit of the surgical treatment. " New endoscopic minimally invasive surgical techniques are being tested with encouraging results.

Thanks sir
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Thanks Dr Prashant . Systemic hypertension show a predilection for certain anatomic locations of hematoma: the basal ganglia ( the putamen in particular),the sub cortical white matter, and the thalamus account for 35% ,25% and 20% of ICHs respectively, where as the posterior fossa locations,the cerebellum and pons are responsible for 10% and 5% of cases. Irrespective of the anatomical locations the common pathogenesis in these hemorrhage involves the hypertension- induced degeneration of the media of small ( 50 to200micron) arteries called " hypo- hyalinosis " and / or the formation of" micro aneurysms " both of which occur preferentially in perforation or small subcortical arteries,thus resulting in the characteristic anatomical distribution of hypertensive ICH.

Hello dr Prashant Vedwan Thanx for tagging me Going through the case of ICH Yes very good and appreciative work done Yes i agree the cases of ICH OR INFARCT should always receive the neurological treatment in WINDOW period of 72 hrs In this case pt has E2V3M4 GCS score hence all good steps were taken Evacuation of ICH in basal ganglia a vital area of brain Pt was negligent of hypertension Congratulations for well managed efforts

Thanx dr Ashok Leel
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MICE ILLUSTRATION INTRACEREBRAL HEMARGHE OR ANY INTRACRANIAL PROBLEMS BE SUBDURAL HEMATOMA STROKE HYPERTENSION R T ACCIDENTS HEAD INJURIES ALL HAVE TO BE TAKEN AS URGENT CASES IMMEDIATE INTERVENSION AND CONSULTATION OF NEURO SURGEON IN HEAD INJURIES IS VERY IMPORTANT IN CASES OF NON TRAUMATIC NEUROLOGICAL DISORDERS CONSULTATION OF NEUROLOGIST IS VERY IMPORTANT

Truly said...intracranial hemorrhage has devastating outcomes unless managed at right time. Thank u for sharing

Useful educative and congratulations to you and team. Comprehensive observations and information sharing with us. Thanks Dr.

Thanks Dr Prasant
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Intracerebral hemorrhage in accident many causes in world.. that kind of situation neurological deterioration, patients head hemorrhage loss eye, manic disorders,coma,and etc.. surgical procedures is best for accident head heamorrhage.. treatment then seen the cases MRI then treatment start by neurologist

Nice thanks like to know the rebound effect of mannitol ⁰

Welldone sir with in. the time Thanks for immediate response t save the Life

Good case learning experience... this is what the best about this platform...

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