TIME IS MONEY : for Large Intracerebral Hematomas

35year old man has been successfully operated for a large Intracerebral Hematoma with a good early clinical recovery, by Dr Harsimrat Bir Singh Sodhi, Consultant Neurosurgeon, at Alchemist Hospital, Panchkula.

Intracerebral Hematoma is a condition in which blood accumulates in the brain due to bleeding within the brain tissue itself. It happens most commonly due to sudden uncontrolled surge in Blood Pressure (Accelerated Hypertension). Patients usually have a past history of irregular medication for hypertension.

Patient Upinder, resident of Kurukshetra, presented to Alchemist Hospital Emergency with complaints of sudden severe headache followed by seizures and then unconsciousness. Patient was highly irritable at the time of admission with a coma score of 11/15 (GCS). CT Scan of Head revealed a Large Intracerebral Hematoma In Right Parieto-Occiptal region with pressure on the brain tissue leading to Uncal Herniation.

Patient was immediately taken up for surgical evacuation of Hematoma, after getting necessary blood investigations done. Hematoma was completely evacuated with good brain pulsatility at the end of surgery (a very positive sign for a Neurosurgeon). Postoperatively, patient made a good and early clinical recovery. He was shifted out of ICU on 5th day and discharged in conscious alert status without any neurological deficit, on 10th postoperative day. Now one month post-surgery, patient is clinically ok without any weakness and has resumed his duty as a Maths Teacher.

Take Home Message by Dr H S Sodhi

> Early surgery and evacuation of clot can lead to complete clinical recovery

> Time should never be wasted in undergoing local treatment or quack therapies if patient has any of the following symptoms

·         Severe Uncontrolled headache (never experienced such severe headache anytime in life)

·         Drowsiness or decreased alertness

·         Limb weakness

·         Headache followed by unconsciousness

Immediately rush to a Tertiary Care Centre with facility for Neurosurgery and a good

ICU back...

Time is Money for such large Intracerebral Hematomas with pressure effect on brain, since early surgery can prevent catastrophic damage to normal brain tissue, effectively preventing development of Coma, prolonged ventilation and hospitalization. This all collectively saves a lot of money and has minimal future financial liabilities, since he/she can lead a normal lifestyle and can earn for themselves.