A 23-year-old man with intraventricular hemorrhage and three other “suspect” lesions.

Corresponding author: Giannantonio Spena, MD, Neurosurgery Clinic, Spedali Civili of Brescia, Brescia, Italy. giannantonios@hotmail.com / tel. +39 030 399 5587 / fax +39 030 399 5003 / http://www.civile.asst-spedalicivili.it / www.gspena.com
A 23-year-old man started complaining of intense headache followed by nausea. Painkillers didn’t work well and after a consultation with his GP, the patient referred to the ER of a primary hospital. Here the patient’s neurological status was good (responsive, oriented in time and space, no motor or sensory syndrome) but with violent headache and vomiting. An urgent CT scan was done which showed intraventricular hemorrhage associated to hydrocephalus (see figure 1). The patient was immediately referred to our Hospital.

Upon arrival in our clinic, neurological status was unchanged.

Figure 1.

Figure 1.

* 1. Based on the CT scan and clinical conditions, what would be your proposal?