A 19-year-old male is brought into the emergency department by the police. The patient was arrested earlier in the evening after initiating a fight at a party.
He was very aggressive, and it took multiple officers to restrain and arrest the patient. Shortly after his arrest, he became unresponsive. A computed tomography scan of his head, complete blood count, and electrolytes are normal. Urinary analysis is normal except for myoglobinuria. On examination the patient
is somnolent but arousable with painful stimulation.
He is hypertensive, is febrile, and has both vertical and
horizontal nystagmus.

SAH

Patients with poor neurological status may require early surgery aimed at addressing complications such as acute #hydrocephalus and intraparenchymal haematomas. Such #surgery can remove the viscous clots from the basal subarachnoid cisterns and place clips on aneurysms before #vasospasm develops

Hydranencephaly (HE)

HE is a rare entity that occurs in utero, in which the cerebral hemispheres are completely or almost completely missing which is transformed into a membranous sac filled with CSF , glial tissue, and #ependyma. The cerebellum, midbrain, BG, thalami and choroid plexus are generally not involved.

Hemihydranencephaly is less common disorder characterised by a unilateral absence of one cerebral #hemisphere.

Several aetiologies have been described, but the hypothesis of bilateral occlusion of the supraclinoid segment of the ICAs

Figure ;
Ballooning of the supratentorial and infratentorial compartments resulting in a secondary meningocele through the sutures, elevation of the #tentorium and ballooning of the anterior and middle cranial fossa.

#neurology