56years old female with H/o sudden loss of consciousness 6 hours back,At present on ventilator support and GCS is E1VTM2,minimal with both pupils dilated.How to proceed further with this case???



Intracerebralhaemmorhage prognosis poor Conservatively manage

I agree with Dr S Kumar

Big intracerebral bleed Only conservative treatment But outcome is poor We can pull on but can’t avoid fatality Relatives need to be explained

Lt inyragangionic cerebral haematoma with intraventricular extension. Continue ABC with antioedema treatment and control BP if any to 150 /90 but not less .Evacuation of blood may be done but prognosis is poor whether to attempt surgical evacuation of blood or continue conservative treatment.

If both pupils are dilated fixed there's not going to be a good outcome whatever you may try Counsel the family with dot consent before proceeding with decompression if that is the plan. But I would not suggest that the surgeon should attempt this.

Big bleed lt thalamo-ganglionic area with bood in the 3rd ventricle with uncal herniation, blood in the 4th ventricle &brainstem.small hyperintense lesion rt parietal area also..Suggest anticerebral edema measures. Urgent Neurosurgical opinion. Location of bleed suggestive of hypertensive bleed

Intracerebral HEMARRHAGE near Internal capsule.. + Reduction of ICT measures +Nimodipine slow infusion+Maintain ABC

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Lignocaine 1 per cent eye drops.

Left gangliocapsular bleed with intraventricular extension Conservative line of management: Ventilatory support Anticonvulsants Cerebral decongestants BP control Supportive management Considering the presenting neurological status prognosis is poor

CT shows left gangliocapdular bleed with IVH, gross cerebral edema and midline shift. CT doesn’t show significant ventriculomegaly or hydrocephalus. Prognosis for such bleed is uniformly poor. DeCompressive hemicraniectomy is and option however EVD can be attempted prior to that. NOK of the patient must be counselled regarding poor outcome even after intervention. AEDs Cerebral decongestants Other supportive measures to continue

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