Right Brain: How to treat the untreatable

Mr. X came in to the hospital late at night. He initially had left-sided weakness and headache but rapidly progressed to decreased level of consciousness (Glasgow Coma Scale score was 4). From home, I reviewed his head CT, which revealed a large supratentorial bleed that had ruptured into both lateral ventricles, and significant midline shift. Without having seen the patient, I already knew that his prognosis for survival was very low.