Concluded Case

cerebellar infarction

25/ M with rhd ,post MVR 5 years back on anticoagulant ,lost to f/w p/w acute headache , giddiness, f/b altered sensorium no h/o fever, cough , dd , management for acute and long-term

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Concluded answer

Rt cereballar infarction with partial obstruction to 4th ventricle with dialatation of 3rd & lateral ventricles.Rt superior cerebellar artery infarction with hydrocephalus due to partial obstruction of 4th ventricle. Continue anticoagulant. Pt lost follow up probably not taking anticoagulant.Needs cardiac evaluation Also check for any other csuse for young stroke. Rept Ct 24 hrs for looking for the status of hydrocephalus.Refer to neurosurgeon for hydrocephalus

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Cerebellar bleed

Cerebellar bleed Iv mannitol Anticonvulsant Check coagulation profile Neurosurgen opinion must

If it is rt cerebellar????infarct ????cardioembolic ,inadequate anticoagulantion

Bp 108/56, INR 1.1 There must be some image visibility issue There is no hyper instead of hypodensity in rt cerebellum

Please post the CT pictures again. Posterior fossa looks rather blurred. CT is not the most helpful in discerning posterior fossa pathology because of bone artefact. Moreover a restless patient's CT brain may end up with motion artefact too. If you say there is hypodensity (it's your patient), then treatment would
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???Bp recordings

?????INR more than 3 or 4 ???anticoagulant induced bleed

Cerebellar bleed Suggest: Anticonvulsants IV Mannitol Check coagulation profile Inj.Vit.K 10mgs IV/OD FFP transfusion Neurosurgery opinion BT CT PT CBC ECG 2D-Echo Routine labs

Since as mentioned there is no hyperdensity INR 1.1 it could also be a posterior circulation stroke However needs further evaluation Suggest: MRI Brain with DWI
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Vertigo diasias tension headache vertigo tables daily two one week myospaz tablet daily two five days panccef az 250mg daily two five days tossex expectorant two teaspoon daily two times day

Bilateral Cerebellar hemispherical hyperdensities ( bleed) with obstructive hydrocephalus. Needs decongestants, neurosurgical intervention for craniotomy or EVD. pt. On which anti coagulants? What is INR?

Large occipito pareital bleed with edeme With midline shift

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