SURGICAL APPROACH IN PRIMARY INTRACEREBRAL LOBAR HEMORRHAGE WITH PROGRESSIVE NEUROLOGIC DEFICIT
Abstract:
Cerebral hemorrhage is the third most frequent cause of stroke, and it's most important risk
factor is hypertension, followed by aneurysms and arteriovenous malformations. We present the case
of a 63 year old male patient with a known medical history of intracerebral hemorrhage following a
ruptured arteriovenous malformation, admitted for a sudden onset of a persistent confusional state.
CT scans showed left frontal intraparenchymal hematoma. The initial therapeutic approach was
conservatory, by administrating antihypertensive, diuretic and hemostatic agents, while
simultaneously decreasing intracranial pressure. Forty-eight hours after admission, we found motor
deficit of the right limbs and non-fluent aphasia, which justified immediate surgical removal of the
blood clot. Following surgery, the patient’s general and neurological status was noticeably improved.
After extensive differential diagnosis, the current affliction was labelled as primary intracerebral
“spontaneous” nhemorrhage, due to hypertension.
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