Received Nov 6, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| RSV | RSV (MRESVIA) | MODERNA | UNK | 30441770 | IM / RA |
11/4/2025 After supper resident was lethargic and not in normal status. Resident in wheelchair arms dangling to the side and not responding. Eyes were closed and shallow breathing was noted. No response from resident by calling her name and shaking her. 911 was called for emergency services. VS i BP178/95 HR:103 T:97.8 R18 O291% on RA BS:258. In the ED Neuro exam: Mental Status: Obtunded, sonorous breathing. Slightly opens left eye with noxious stimuli. Decerebrate posturing in the bilateral upper extremities with noxious stimuli. No movement or withdrawal in the lower extremities. GCS: 5 Radiological Review: Head CT reveals a large right basal ganglia hemorrhage with ventricular extension and acute hydrocephalus. Assessment: Encephalopathy., Basal ganglia hemorrhage., Intraventricular hemorrhage. Hydrocephalus Patient continues to be intubated and in the hospital. (11.6.2025)
no illness within a month.
past medical history significant for Hodgkin's lymphoma complicated by paraplegia secondary to her radiation now in remission and Spinal cord injury in. Current has open wounds, left popliteal open wound Wound care being by nursing in LTC facility, Chronic Foley, GERD without esophagitis
Pantoprazole, Digestive Enzyme Oral Capsule (Digestive Enzymes), Fish Oil Oral Capsule (Omega-3 Fatty Acids), Ginseng Oral Capsule (Ginseng), Cholecalciferol Oral Tablet (Cholecalciferol), Ferrous Sulfate Oral Tablet 325 (65 Fe) MG (Ferro
Albuterol
Intubated, bilateral frontal ventriculostomies - Bilateral, Head CTX 2, MRI and MRA. CT IMPRESSION 11/4/2025 2340 1. Similar appearance of the acute intraparenchymal hemorrhage centered within the right basal ganglia and thalamus, with surrounding edema and localized mass effect. 2. Large amount of intraventricular hemorrhage throughout the lateral, 3rd, and 4th ventricles with associated hydrocephalus and transependymal CSF flow, similar to prior study. Interval placement of bilateral frontal-approach ventriculostomy catheters. CT IMPRESSION 11/5/2025 0542 IMPRESSION: 1. Obstructing hydrocephalus not improved 2. Very similar volume thalamic hematoma 3. Suggestion of pre-existing chronic small-vessel disease accounting for periventricular hypoattenuation and likely old pontine infarcts. 4. Frontal ventriculostomy catheters appear unchanged MRI HEAD 11/5/2025 10:57 IMPRESSION: 1. Stable extensive intraparenchymal hemorrhage centered on the right thalamus with extension into the ventricles. 2. Bilateral ventriculostomy catheters via high frontal approach. Similar degree of ventriculomegaly. 3. Ill-defined non masslike enhancement in the right thalamus at the periphery of the intraparenchymal hemorrhage probably related to blood-brain barrier breakdown. No discrete mass. 4. No evidence for acute ischemia MRA HEAD 11/05/2025 9:54 AM FINDINGS: No evidence for focal aneurysm in the anterior or posterior cerebrovascular distributions. No evidence for hemodynamically substantial vessel narrowing in the anterior or posterior cerebrovascular distributions. MRA CAROTICS 11/5/2025 10:51 AM IMPRESSION: No evidence for hemodynamically significant stenosis or occlusion. EEG completed 11.5.2025 1228 am This is an abnormal study due to presence of excessive background slowing. No interictal or epileptiform activity is noted. Plans for Palliative Care consult 11/6/2025. CT head 11/4/2025 Large 2.7 x 2.3 x 2.6 cm intraparenchymal hemorrhage of right basal ganglia. Intraventricular extension with large amount of blood within the lateral, third, fourth ventricle. Moderate to marked hydrocephalus. Transependymal edema. Repeat CT head 11/4/2025 Similar appearance of acute intraparenchymal hemorrhage. Surrounding edema and localized mass effect. Large amount of intraventricular hemorrhage throughout the lateral 3rd and 4th ventricle with associated hydrocephalus and transependymal CSF flow, similar to prior study. Interval placement of bilateral frontal approach ventriculostomy catheters. CT head 11/5/2025 Obstructive hydrocephalus not improved. Very small volume thalamic hematoma. Suggestion of pre-existing chronic microvascular changes accounting for periventricular hypoattenuation and likely old pontine infarct. Frontal ventriculostomy catheters appear unchanged. Chest x-ray 11/4/2025: ET tube and NG tube in good position. No acute cardiopulmonary pathology.