PHILIPPINE GENERAL HOSPITAL
DEPARTMENT OF NEUROSCIENCES
Section of Neurosurgery
TOTAL NUMBER OF PATIENTS: 35
Inpatients: 35
Admission: 1
NSSCU (7)
BED #
1
GENERAL DATA
SORIANO, Jaybee
23/M
CN 3532031
DOA:
Discharged: 1
Out on pass: 0
PRESENT WORKING IMPRESSION
Meningioma
2
3
4
LAMPA, Teresita
61/F
CN 3523701
DOA: 1/14/10
ACID, Joana
31/F
CN 3465827
DOA: 1/29/10
TALOB, Ericson
36/M
CN 3457331
DOA: 1/22/10
MORTALITY: 0
HAA: 0
Tumor recurrence
Sp/ SOC, C1-C2 laminectomy, excision of foramen magnum meningioma (1993, 2000)
T/C Tumor Recurrence
S/P Re-op Right frontotemporal Craniotomy
Excision of Tumor (Seng 2/15/10)
Neurofibroma C2
S/P C1 laminectomy, C2 hemilaminectomy Excision of Tumor (2/17/10 Pua)
5
6
7
8
AGUILAR, Edilberto
62/M
CN 3360230
DOA: 2/17/10
LENTIJA, Ricardo
46/M
CN
DOA: 2/2/10
VACANT
RAMOS, Delfin
61/M
CN 3536341
DOA: 2/12/2010
R Meningioma S/P Cranio Excision (12 2008) s/P tumor Recurrence (1995)
MI 2 o
VC
1. t/c Traumatic Brain Injury
2. Abrasion, R temporal, L thigh
T11-T12 extramed intradural tumor
T/C Hemangioma vs Hemangioblastoma
S/P T11 Laminectomy T12 partial laminectomy
Excision of Tumor (Pua, 2/18/10)
PLAN/S
Dec Dexa to 4 mg/tab q8 x 2d then 1 tab q12
Rpt Na, K, Ca
For removal of JP drain tom
Remove IFC
FF up lab results
Cont present mgt
Cont Rehab
Dec Dexa to 4 mg/tab q8 x 2d then 1 tab q12 x 2d then 1tab x 2d then ½ tab x 2d then d/c
Repeat Na, K today
D/C Mannitol
FF up post op labs
D/C O2 support
Cont antibiotics
Referral to Rehab informing pt’s location dropped
Anesthesia: Referral to Cardio for note of ST depression intra-op (previously seen by cardio)
For EEG on Fri at 2pm
FF CBC, PT/PTT, ECG and CXR if not yet done
Referral to Gen Med dropped
Referral to Neuro informing of patient’s location dropped
No antibiotics given, still for securing funds
Refer to MSS
Transferred from W6B14 S/P Laminectomy
Referral to Rehab dropped
Meds: Ketorolac 30 mg IV q6
Tramadol 50mg IV q6
Cloxacillin 1 g IV q6
Gentamycin 240 mgIV q6
Celecoxib 200 mg cap BID
Resume Bisoprolol 5mg/6.5 g QID once feeding

WARD 6 (22)
BED #
1
2
3
4
5
6
GENERAL DATA
SUGNAN, Madelyn
22/F
CN 3531213
DOA: 1/26/10
SANTUROL, Ma. Rhona
39/F
CN 3491119
DOA: 2/02/10
LEDESMA, Lazaro
46/M
CN 3525474
DOA: 1/22/10
NOE, Raymond
24/M
CN:
DOA: 2/8/10
VACANT
DALIGDIG, Rhona
38/F
CN 3532362
DOA: 2/4/10
7
8
9
10
11
12
13
14
15
PALMES, Flordeliza
55/F
CN 3532281
DOA: 02/03/10
LOPEZ, Jericho Joel
4mos/M
CN 3468947
DOA: 2/13/2010
KAPALUNGAN, Richard
46/M
CN: 3472975
DOA: Feb 7, 2010
DAGIUO, Arceli
46/F
CN 3532255
DOA: 2/14/10
BAYLOSIS, Albert
50/M
CN 3531124
DOA: 1/20/10
HERRAS, Medita
50/F
CN: 3526573
DOA: Feb 11, 2010
ABATIR, Jerome
7/M
CN 3468947
DOA: 2/12/10
VACANT
DONAN, Robby
15/M
PRESENT WORKING IMPRESSION
SAH Gr II prob 2º to ruptured aneurysm
Right parasagittal meningioma
Pituitary Adenoma
Posterior Fossa Mass
Moya-moya Disease
Intracranial mass R parietal prob meningioma
HCP
Vertebral artery aneurysm L
PLAN/S
For possible CT Angio tom
D/C Etoricoxib
Resume feeding if not yet fetched to OR by 12 nn
Still not yet ready for surgery due to poor financial support
For home per request in 1-2 days
For cranial CT plain tom
For d/c tom if without problems
Transferred from NSSCU B7
Clinical abstract and discharge summary updated
For CF perfusion studies on OPD
For d/c once ok with all services
IDS: D/c antibiotics. Signing out
Allergy; no objections for d/c. Ff up at allergy OPD clinic
For OR scheduling
For CSF culture
For d/c tom
ROD to provide quotation for angio and OR needs
R vestibular Schwannoma
Papillary Thyroid CA
Facilitate thyroid UTZ tom
D/c any further intake of LEvothyroxine
L parietal brain fungus, depressed skull fracture s/p L parietal debridement, craniotomy, evacuation of hematoma, duraplasty (Hao 1/21/10) s/p Re-open debridement duraplasty with TFL
(2/1/10)
Intradural extramedullary mass compressing the spinal cord and conus medullaris T10-T12
Bronchial asthma, controlled
Lipomyelomeningocoele
Cont Meropenem for 14 days
D/C Celecoxib
Do CXR, CBC today
For rpt UA tom
Cont antibiotics
Possible d/c tom if without problems
Cerebellar pilocytic astrocystoma s/p SOC, excision of tumor (Seng 1/28/10)
For cranial CT today

18
19
16
17
20
21
22
CN 3522424
DOA: 1/22/10
REYES, Precious
18/F
CN 3517280
DOA: 1/4/10
BALTAZAR, Restie
33/M
CN 3523707
DOA: 1/13/10
VALENCIA, Mario
36/M
CN 3531637
DOA: 2/3/10
FERNANDO, Eulogia
46/F
CN 3532598
DOA: 2/13/10
MORENO, Danilo
36/M
CN 3531020
DOA: 1/18/10
LIWANAG, Amelyn
12/F
CN 3408073
DOA: 12/27/09
DOMINGO, Urick Priam
24/M
CN 3531949
DOA: 1/30/10
27
28
TANGHAL, Fernando
52/M
CN 3517628
DOA: 2/3/10
RAMOS, Ruben
24/M
CN: 3531693
DOA: 1/27/2010
WARD 14A (2)
BED #
2
GENERAL DATA
DOROTEO, Jan Nathan
5 mos/M
CN 3505111
DOA: Feb 13, 2010
18 MARINDUQUE, Nilo
22/M
CN 3532468
DOA: 2/5/10
L TEDH, L TCH, R TCH s/p L hemicraniectomy, evacuation of hematoma, duraplasty (Hao 1/4/10)
L vestibular schwannoma
For CSF sampling today
Cont IV antibiotics
Start bladder training
Remove FC tom AM
SCC sec to C3-C4, C4-C5 disk protrusion with OPLL contusion C4-C5
For OR scheduling
May shift Paracetamol to PRn for fever >= to 38 degC
R parietal mass t/c astrocytoma
SCI C4-C5
For MRI with GAD cranial
For tapering of meds after scan
(+) 4 blood donors
For scheduling of surgery
For Urine GS/CS
Surgical site infection
R FTP ASDH s/p R FTP decompressive craniectomy, evacuation of hematoma (SLMC 1/24/10) s/p Tracheostomy (2/12/10 Villamor)
Glioma s/p craniotomy, excision of tumor (1/19/10)
SAH Gr I sec to ruptured R MCA artery aneurysm s/p micropterional craniotomy, clipping of aneurysm
(2/12/10)
Cont traction for now
Cont Bactroban ointment
Wound swab
Clinical abstract and discharge summary updated
MGH
Home meds:
MVS tab OD
Vit C OD
Omeprazole 20 mg/tab OD x 7 days then d/c
FF up NSS OPD 2/22/10 12 nn at 2CO6
Possible referral to GS1 as OPD for possible tube G..
Transferred from NSSCU B4
Rpt Na, K today
Start FeSO4 BID
Clinical abstract and discharge summary updated
D/C Levophed
For d/c tom if without prob
Shift Citcholine 1g tab a12
Start Dolcet TID prn for HA
PRESENT WORKING IMPRESSION
Congenital Hydrocephalus preb sec to AS
Myelopathy T1-T5 probably 2 to TB
PLAN/S
Pedia clearance done
For surgery tom as first case 12nn
NPO at 6am
Meds PTOR:
Celecoxib 120 mg
Gentamicin 40 mg IV
Cont IV antibiotics

PACU (4)
BED # GENERAL DATA
YANELA, Jacinto
47/M
3536187
DOA: 2/10/10
BARBA, Herminio
353647
2/14/2010
STA. ANA, Eddieboy
23/M
3536499
2/14/2010
FLORES, Rafael
41/M
CN 3530005
DOA: 2/3/10
DISCHARGES(1)
BED # GENERAL DATA
6 ROSALINDA, Gleceria
47/F
CN 3517160
DOA: 1/2/10
PRESENT WORKING IMPRESSION
GSW, occipital area s/p debridement, craniectomy, evac of hematoma
L FTP EDH
MI sec to VC
L FCH L FTP SDH s/p decompressive hemicraniectomy (Hao, 2/15)
Intramedullary mass C4-T2
PRESENT WORKING IMPRESSION
Pituitary macroadenoma, non-functional
PLAN/S
Cont meds
For transfer to W6B27
For JP drain referral tom
Start celecoxib 200mg/tab BID
For repeat CBC, Na, K, Cl, Bun, Crea tom
Dec FiO2 by 10%/hr until 30% then ABG after 2 hr
PLAN/S
Home meds:
Amlodipine 10mg/tab OD
Mefenamic acid 500mg/cap
OPD ff up on 2/24 7am
Endo ff up 2 weeks wed pm, rpt serum cholesterol