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POST CEREBRAL CONCUSSION

42yrs old male patient was admitted as 3days old case of RTA with head injury.CT brain was normal.Known diabetic on treatment.On 5th day patient developed necrosis of upper half of his face and loss his vision too.MRI brain with contrast was done which S/o Cavernous sinus DIAGNOSIS AND MANAGEMENT??

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CVT can be catastrophic.. I would like to see mri of this pt ?? What about current sugar status ?? If it is just a thrombosis , it still easy but if it got infected thrombus than it is disaster..!!! Must rule out infection before starting anti coagulants Get help of plastic surgery people for reconstruction of face

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Plastic surgery will be the later option First of all, how to subside the necrosis . Chiasmal field defect, due to peripapillary hemorrhages, # swelling ++++ thrombosis Anticoagulant Higher antibiotics like Meropenem Hyrdrocortisone Mannitol Corticosteroids Buccal area should be dressing by proper... SpO2 continue BP will be raised so manage For further best management consultant to neuro surgeon.

Why Mannitol, if no intra cranial bleeding. Absurd opinion
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Cavernous sinus involves Cranial nerve 3rd and in 89percent cases opthalmic artery arises from cavernous sinus post cavernous. So there is opthalmic artery occlusion and may be avulsed 3rd cranial nerve or cavernous sinus thrombosis....

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Thank you doctor
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@Dr. Prashant Ved would suggest you to please post MRI scans of the patient as for necrosis it may be due to elevated blood sugar levels , finally for the face and eyes pls involve a plastic surgeon for reconstruction

Sir,thanks for ur valuable opinion Dx - Mucormycosis
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CVT can be catastrophic.. I would like to see mri of this pt ?? What about current sugar status ?? If it is just a thrombosis , it still easy but if it got infected thrombus than it is disaster..!!! Must rule out infection before starting anti coagulants Get help of plastic surgery people for reconstruction of face

Sir,at present MRI not available,The diagnosis was made mucormycosis he did not respond to treatment and died.
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Start with anticoagulant and higher antibiotics. Neurology consultation

Enoxaparin .6 mg Sc And symptomatic Prognosis worse

Subclavian arterial injury or thrombosis also