Case Discussion and Plan

1. 19TH ANNUAL CONFERENCE OF
CEREBROVASCULAR SOCIETY OF
INDIA
WORKSHOP
13th SEPTEMBER 2019
Dr Fakir Mohan Sahu
MCh Neurosurgery
AIIMS Bhubaneswar

2. A 65/F, presented on dt. 30/08/2019
C/o:
 Thunder clap headache: :3 wks
 Vomiting(2 epi.) :3 wks
-No h/o LOC, Seizure, weakness of limb
Past h/o:
 HTN( 5 years)- on medication

3. Average built and nutrition
Afebrile
PR-80/min
BP-130/70 mmHg
RR-20/min
Spo2-99%

4. CNS EXAMINATION
Higher mental function:
 Conscious, oriented
 Following command
 GCS:E4V5M6
Cranial nerve: intact
Motor system:
 Power in all 4 limb 5/5
 DTR- normal
 Plantar : B/L down going
Superficial reflexes: normal
Sensory system-intact
Cerebellar sign- absent

5.  NCCT HEAD(21/08/2019)
- SAH(RUPTURED ANEURYSM)
- SMALL RIGHT FRONTAL
LOBE HEMORRHAGE
- LACUNAR INFRACT IN
LEFT GANGLIO-CAPSULAR
AREA

6.  Left DACA Aneurysm(2×2mm)
directed Antero-superiorly, bovine
arch
 Right ICA supraclinoid aneurismal
dialatation

7. RUPTURED LEFT DACA ANEURYSM
(Right ICA Supraclinoid Fusiform Aneurysm)
H&H-I, WFNS-I, mRS-0

8. Coiling of Left DACA Aneurysm