Clinical Summary: Post-Operative Management of Cerebral Ventricle Neoplasm

Patient admitted for removal of a malignant neoplasm in the cerebral ventricle. Surgical interventions included a bifrontal craniotomy for tumor excision and external ventricular drain (EVD) insertion, followed by a second surgery for intracerebral hematoma drainage and ICP catheter placement.

The patient remains ventilated with ongoing neuro-protective measures. EVD status has progressed from blood-stained to clearer drainage. Intracranial pressure (ICP) is generally well-controlled (0-6 mmHg). Neurological observations are continuous, with pupil size monitoring and sedation maintained via morphine and dormicum infusions.

The patient exhibits cardiovascular instability requiring inotropic support, specifically noradrenaline, although this was intermittently tapered. Persistent pyrexia necessitated septic workups and antibiotic adjustments. Ongoing care includes nutrition via TPN and NGT, strict fluid balance management, and VTE prophylaxis.

Comprehensive pharmacotherapy includes broad-spectrum antibiotics (Rocephin, Cerepiv), anticonvulsants (Alepet), corticosteroids (Dexona), and gastrointestinal support (Pantocid, Metoclopramide). Allied health support from physiotherapy and dietetics continues throughout the TICU stay.