Quick Case: Intracranial Bleed

Abstract

Sudden increase in blood pressure at times can be dangerous. It can lead to bleeding anywhere in the body. Smooth control of blood pressure is a must for all. Regular monitoring is also mandatory. In this patient, a stable CKD patient, possible sudden increase in blood pressure lead to intracranial bleed, the presentation was confusing.

Intracranial hemorrhage (i.e., the pathological accumulation of blood within the cranial vault) may occur within brain parenchyma or the surrounding meningeal spaces. Common symptoms include: Alteration in level of consciousness (approximately 50%), Nausea and vomiting (approximately 40-50%), Headache (approximately 40%), Seizures (approximately 6-7%)

Case Report

Female patient, 62 years old with a past history of CKD and Diabetes.

Examination

Early in the wee hours of morning there was a house call. Presented complaint was strange. The patient started to cook in the mid night. She was conscious and mildly disoriented. She could recognize me. Responded well to all the queries. Seem to be disturbed.

Investigation

Findings:
Blood Sugar: -245
Blood Pressure: 140/90mm Hg.

Management and Follow-Up

Since she was a patient with CKD, some disturbances in electrolytes and kidney function was suspected. Tests were advised for the same. The test result was not remarkable. She was referred to a physician, who could not find anything special. A neurosurgeon was involved suspecting something wrong with CNS. CT scan brain was advised. That has clinched the diagnosis. There was subdural Hematoma. Burr Hole surgery was done and patient improved.

Patient is doing fine today.

About The Author

Dr. Vachharajani is an experienced practicing family physician in Ahmedabad, Gujarat, with a special interest in obesity and lifestyle-related disorders. With a genuine passion and enthusiasm for healthcare information technology (HIT), he has championed the cause of using HIT in day-to-day clinical practice. In addition to his, MBBS, he holds a post-graduate certificate in environmental and occupational health (PGDMCH).

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