Second Attack Hemorrhage Stroke in Patients with a Previous History of Ischemic Stroke with Hydrocephalus Exvacuo

Abstract

A second attack stroke is a nightmare for patients especially eldeily patients. This stroke is the most prevalent consequence of stroke with a substantially greater fatality rate than a first stroke supported by a history of uncontrolled hypertension of diabetes mellitus (DM), individual experience with ischemic stroke, family record of ICH, low cholesterol levels, as well as warfarrn administration especially in the event of ICH. A woman, Mis. M, 68 years old, with complaints of sudden weaknees on the right side and slurred speech since 1 hour before entering the hospital, the patient has a record of hypertension, DM, and with a history of sudden visual impairment with a final diagnosis of ischemic stroke 6 months ago. The results of the CT-scan (Commuterazide Tomogipahy) without contrast showed a hyperdense lesion in the left temporalis, the bleeding volume was ±34.28 cc surrounded by cerebral edema and the cortical sulci looked wide, the gyri were prominent, the ventricular system also looked wide, there was no midline shift, cerebral atrophy with hydrocephalus communicans type hydrocephalus exvacuo infarction long in the left occipital lobe. The patient received therapy with medication for hypertension, DM, mannitol, vitamin K, and intracerebral bleeding was carried out with craniotomy for indications of hemotoma and there is no therapy for exvacuo hydrocephalus.