61yo M with medically controlled hypertension presents to ER | Figure 1

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61yo M with medically controlled hypertension presents to ER with severe headache, vomiting, lethargy. Able to answer questions, move 4 extremities and follow commands. CT (image 1) shows intraventricular hemorrhage likely related to HTN. Pt also stated he "sunk to his knees when we felt a terrible headache" striking the right side of his head on a cabinet causing a ceohalohematoma. Following CT, the patient became obtunded, non responsive requiring intubation. Bedside ventriculostomy was placed to decompress the ventricles, opening ICP was 28mmHg (<20 considered normal). On day 2 pt exam was improved. Ventricular catheter had closure/clamp trial on day 5. No exam change was observed and catheter removed. Pt transferred to rehab, awake, alert, moving all 4 extremities.

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