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Hematocrit effect

Case contributed by Swaleh Mohamed Mohamed
Diagnosis certain

Presentation

Sudden loss of conscious after metalyse (tenecteplase) administration post treatment of acute myocardial infarction.

Patient Data

Age: 50 years
Gender: Male
ct

There is a massive acute right parietal region parenchymal hemorrhage with fluid-fluid level in keeping with hematocrit effect. Associated contralateral subfalcine herniation is noted.

Hyperattenuating floating clots are seen within the hemorrhage.

Case Discussion

50 year old man presented with typical ECG and laboratory diagnosis of acute myocardial infarction. Metalyse (tenecteplase) was administered in ICU. The patient developed sudden loss of conscious with GCS of 3. CT head done showed massive acute right parietal region parenchymal hemorrhage with fluid-fluid level in keeping with hematocrit effect. Hyperattenuating floating clots are seen within the hemorrhage.

Conservative management was preferred.

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