Blood in the Brain

Before ending my duty today, a 34 year old male was brought to the ER unresponsive. Patient was seen approximately an hour before lying on the floor and noted to have drooling of saliva. Upon arrival at the ER, patient was noted at GCS 4 with anisicoria. A cranial ct scan revealed an intraventricular bleed with an amount roughly reaching 100cc. Patient was intubated, hook to mechanical ventilator and admitted under neurosurgery service.

CVD bleed or hemorrhagic stroke occurs when a blood vessel in the brain ruptures and spills blood causing in compression to the other brain structures. They are more likely to have headache, altered mental status, seizures, nausea and vomiting, and/or marked hypertension, however this mentioned symptoms could also be seen on ischemic stroke cases. It can be cause by hypertension, an aneurysm or less common from an AV malformation. The amount of blood/bleeding determines the severity of the disease and the possible prognosis of the patient.