Concluded Case

Diffuse multiple intraparenchymal hematoma with mass effect

Titles. A case od abrupt loss of conciousness Chief complaint- 71 yr,M. History from the family members.Apparently well till 3 PM on 19th sept2022, While sitting on the chair fell towards the left side ,sustained injury to the left forehead following which he became unresponsive. Arrived at ER at pM on the same day.Denied having any seizure. Medical history- Post COVID 3 months ago Pontine infarction 2 yrs ago on duel antiplatelets. Hypertension 3 yrs on med . Diabetic type 2 on insulin BpH on med Vitals- Deeply unconcious on arrival at ER. BP 90/50mmhg.HR52/ mt. Respiratory rate32/ mt. Afebrile,saturation 82%. Physical exam. Deeply unconcious ,no response on painful stimulation. Pupils3mm,nonreacting DTRS absent .Platars 0 bilaterally. Left forehead swelling with hematoma noted. Investigations- Urgent CT brain done Diagnosis- CT brain shows muliple hyperdense lesion in the brain ,details keeping for discussion. Management- On arrival at ER he was inyubsted and mechanically ventilated. Given IV Leviteracetam. Involvectye Neurosurgeon. Questions What is the diagnosis? How is the prognosis?

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Concluded answer

CT findings Diffuse multiple intraparenchymal hematoma with surrounding mass effect and edema scattered throughout both cerebral hemisphere. × pisterior intrafalcian SDH. × Mass effect with effacement of left lateral ventricle ×Hemorrhagic csf density involving the splenium of corpus callosum ,occipital horn of lateral ventricles suggestive of intraventricular ×Inteapatenchymal hematoma involving corpus csllosum bilaterally and rt lateral aspect of genuine. ×Diffuse bilateral periventricular subcortical white matterhypodensity. × Left paramedian old infarct. The family opted for End of Life Care which was appropriate decision and the death was unavoidable.

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CT findings Diffuse multiple intraparenchymal hematoma with surrounding mass effect and edema scattered throughout both cerebral hemisphere. × pisterior intrafalcian SDH. × Mass effect with effacement of left lateral ventricle ×Hemorrhagic csf density involving the splenium of corpus callosum ,occipital horn of lateral ventricles suggestive of intraventricular ×Inteapatenchymal hematoma involving corpus csllosum bilaterally and rt lateral aspect of genuine. ×Diffuse bilateral periventricular subcortical white matterhypodensity. × Left paramedian old infarct. The family opted for End of Life Care which was appropriate decision and the death was unavoidable.

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