Aster

RV HOSPI TAL
We'll Treat You Well

DISCHAR GE SUMMAR Y
UHID: ABH0020000020791
- Patient No: - .
IR20001899 '
Patient Name: Mr.BABU PA Age ( Gender ): 58V (Male)

-"
Admission Date: 06/04/2020 15:04 DlschargeOn 13/05/2020
Bed No: 506E(FIFTH FLOOR RV) Discharge Type: DAMA
Sponsor: SELF Primary Physician: NEUROSURGERY TEAM
Clinical Dept: NEURO SURGERY Phone: 7356869754
Line of Treatment: SURGERY Date of Operation:
Address: MB CASTLE Al>ARTMENT FLAT NO 402. KALENA AGRAHARA , GOTTIGERE. BANGALOR E.
KARNATAK A. INDIA. 560076.
- - - - - -- - - -- - - -- - -·- - -----
REASON FOR Acute hemorrhag ic stroke (loft ca~slllo ganglionic bleed)
ADMISSION

DISCHARGE Left capsulogan gllonlc bleed secondary to ruptured left parletal AVM
DIAGNOSIS

HISTORY/ History of sudden onset of vomiting followed by altered sensorium since 1.30pm on
COMORBIDITIES 02-04-2020 while he was at ATM
Patienf is in 3ltered sonsorium since then, was initially taken to NIMHANS and sub-
.c..Se.quently was treated at a private hospltal"{Sai Ambika hospital)
He was on ventillator till pre~iol!§. .11ig!lt(03-04:2020) and now on endotrachc al tube with
oxygen suppliment ·- - __ ,___ - _:_ .........
Patient attenders have noted right side weakness and aphasia since then ......_
He is a known sntoker and alcoholic since 30 years
ALLERGIES No known allergies

CLINICAL GCS- E1M3Vt

EXAMINATION: Pupils bilateral 2mm sluggish
Moving left upper limb only, right hemiplegia
Febrile-101
BP.:'170/11 ~ mmHg

11A INVESTIGATIONS MRI brain(04-04-2020) at Ragav diagnostic- left capsulogan glioni~ bleed with abnormal
49~ DONE conglomera te of vessels in the left parietal region suggestive of ?AVM, mass effect
present, midline shift present.

CT brain(07-04-2020)~
Diffuse intraparenc hymal hemorrhag e noted on left sido involving temporal
) ,frontoparie tal region, Left basal ganglia with extension Into left lateral ,entricle, 3rd vent-
ricle, 4th ventricle and right.lateral ventricle.
Perileslona l gross edema noted.
Diffuse subarachno ld hemorrhage noted in bilateral cerebral hemisphere.
Calcificatio ns noted In left parletnl a·rea
Mid nne shift to right side of about 11 .4 mm.
Cerebral atrophy noted.
Rest of the brain parenchym a shows normal attenuation
. .
PROCEDURE Left temporal cr.anlotomy and evacuation of hematoma with trachoosto my under GA on
DONE/OPERATIVE 07-04-2020. ~
NOTES
F~ndlngs - Dura tense and bulging, abnormal dilated veins seen on the posterior tempor~I

• Ge nerated 8yRVDUTYDR on 14/06/2020 16:50 ()

Alter RV Ho1pital,
CA-37, 24th Main, lit Phase,
J.P. Nagar, Bengal.uru • 560078, India Tel: +91802204 0400
E: customercare:aster@as1erh ospital.com www.asturl>n11gn lor~.co1n
AsterPITAL
RV HOS
We'll Treat You Well

DISCHARGE SUM MAR Y

Patient No: IR20001899
UHID: ABH0020000020791
Age ( Gender ): 58Y (Male )
Patient Name: Mr.BABU PA

y done on area of middl e tempo ral

cortex and sroum nd the sylvla n fir.sure, cortls ectom
evacu ated comp letly, hemo stasls
gyi-us which had no abnor mal vesse ls, hema toma
achiev ed, brain lax and pulsa tlle.
oned histor y and findin gs. After
COURSE IN THE This 58 year old gentle man prese nted with above menti
alread y on Inject ion plptaz wfth en•
HOSPITAL overn ight obser vation and once fever settle d (patie nt
haem atoma and midlln e shift was
dotrac heal tube) CT head scan was done. Size of the
atoma , It was decid ed to evacu ate the
signif icant. In view of poor GCS and large haem
hter and son-In -law) were expla ined about the
haematoma. Patien t's attend ants (daug
the risk to his life. They were also
need of surge ry to evacuate the blood clot and reduc e
speec h distur bance may not re-
expla ined about right sided hemiplegla(weakness)and
that there Is a under line AVM
cover even after surge ry. They were also explai ned
side of the brain which may need 'd'efinitive
(vasc ular malfo rmatio n) mainl y on the left
he recov ers from prese nt crisis.
proce edure to diagn ose and to treat subse quent ly once
al ventil ation In the post opera tive
They were amply explai ned about the need for artlflti
exten sive neuro -rehab ilitatio n pro-
period and prolon ged stay in ICU and in hospi tal and
proce edure , prolon ged stay and furthe r care
gram. Finan cial implic ations of the surgic al
nt, patien t under went above menti oned proce dure
were also explained. With their c~se
ventil lated and was gradu ally
Includ ing trache ostom y. Post opera tively patien t was
istere d appro priate antibi otics and
weaned off tile ventil l~or on 11-04-2020. He was admin
a: impro vem_!Q ! in his senso rium to a level of
antiedema measures. He showee:k gradu
ostomy:-He -was shifte d to wards
E2M5Vt. He required oxyge n suppl iment throug h trache
al impro veme nt in his senso rium
on 15-04-2020. In the ward he has been showi ng gradu
right hemlp legia, reduc ed move ment of left
to the state of GCS E4M6Vt with persis tent said and respo nds to
onally compr ehend what is being
lower limb, patien t is able to emoti
le, maint aining satura tion at room
simple verba l commands. Patient has remained afebri
episo des of loose stools , not subsi ding
air, with no press ure sores. Patient had recurr ent
entero loglst opinio n was sough t and sigmo ido-
to medic al management hence gastro
tly loose stools has subsi ded with
scopy was done on 07-05-2020 to rule out colitis curren
feeds. Patien t family has been made
cours e of antibi otics. He is fed by ryles tube and oral
trache ostom y and neuro rehab ilitatio n. Patien t needs
aware that he needs prope r care ,of
ation centre for prope r care of
to be taken either to a nursing home or neuro habilit
ned to the family . They have also
trache ostom y and rehabilitation, which has been explai furthe r treatm ent in due
needs evalua tion and
been made aware that left sided AVM
4t course.
tadine, analg esics, periop erativ e
MEDICATIONS Suppo ~ive medications, antiedema, antiep lleptic s, aman
ADMINISTERED antibi otics

CONDITION AT GCS-E4M6Vt
DISCHARGE Pupils equal and reactive
Right hemlplegla
Woun d health y
RT In situ
Trach eosto my in situ
Catheter In situ
Left lower limb minim al movemont

ADVICE ON 1) Tab Metronidozole 400mg 1-1 -1 x tlll 21-05-2020

DISCHARGE 2) Cap VSL #3 1-0-0 X till 21-05-2020
3) Levlpl l 500 mg 1-0-1 to contin ue
4) Tab Metfo rmln 500mg 1-0-1 >< contin ue
\
Page2 of 3
• Generat ed By RVDUT YDR on 14105/20 20 16:50 ()

Aster RV Ho1pltal,
CA-37, 24th Main, 1st Phase, .
Tel : +91 80 2204 0400
J.P. Nagar, Bengaluru - 560078, India
E: customercare.aster@asterhospital.com www. 11stllrhnngnloro .co111
Aster
RV HOSPITAL
We1 TrNtYou Well

DISCHARGE SUMMARY
---
UHID: ABH0020000020791 Patient No: IR20001899
Patient Name: Mr.BABU PA Age ( Gender ): 58Y (Male)

5) Tab Amaryl 1mg 1-0-0 x contlnll~-

6) Dally bath and hygiene
7) Chest and limb physiotherapy
8) Air bed~
9) Frequent position change
10) Back, ~owel and bladder care •
11) Tracheostomy care/catheter care/ RT care

DIET ADVICE Semisolid food-orally with RT feed

FOLLOW UP DATE Follow up after 1week with Neuro&i,rgery team with prior appointment.
AND REVIEW
0 WHEN TO OBTAIN Fever, seizure, vomlttlng, fresh neurological deficits.
URGENT CARE

CONSULTANT Dr. BA CHANDRAMOULI

M.Ch Neurosurgery(forme r Profes5,2r and HOD Neurosurgery NIMHANS)
LEAD CONSULTANT· NEUROSURGERY

Dr. SUDHIR S PAI

M.S, M.Ch Neurosurgery(AIIMS-Now Delhi)
SENIOR CONSULTANT - NEUROSURGERY

Dr. DHANANJAYA I Bl-tAT

M.Ch Neurosurgery(forme r Professor and Unit Head Neurosurgery NIMHANS)
SENIOR CONSULTANT - NEUROSURGERY

Dr. SANTHOSH KUMAR SA

M.S, M.Ch Neurosurgery(NIMHANS), DNB
SENIOR SPECIALIST - NEUROSURG::RY

Fo, ~ E CONSULTANT

' Generated By RVOUTYOR on 14/05/2020 16:50 ()

P119e 3of 3

Alter RV Hotpltal,
CA-37, 24th Main, 1st Phase,
J.P. Nagar, Bengaluru • 560078, India Tel : +91 80 2204 0400
E: customercarc.a1ter@asterhospital.com www.11stcrh1111g11lorc.c11111
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