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Intracranial hemorrhage in CKD patient case

History: A 47-year-old male was brought to ED in an unresponsive state with h/o 1 episode of seizure at home. He is k/c/o CKD5 on MHD twice weekly. BP – 200/120 mmHg, P -118 bpm, Sp02 – 92 % on RA. GCS – E2V1M4. B\L plantar – mute. RBS – 124 mg/dl. ABG (on o2 support) – PH 7.35 PCO2 34.4 PO2 106  HCO3 19.3 Lac – 4. NCCT head was done. What’s the diagnosis?

Answer: NCCT head reveals Intraparenchymal hemorrhage bleed with surrounding edema in left fronto-parieto-temporal, left gangliocapsular region and thalamus extending to the ventricular region with midline shift towards the contralateral side. The patient was intubated i/v/o low GCS and was admitted to the neurosurgery ICU after giving Inj. Levetiracetam 1.5 gm, Inj. Furosemide 40mg, IVF 3% Nacl.

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