Five of these patients with intracranial bleed were managed in neurosurgery unit. All the patients had deranged prothrombin time and thrombocytopenia. They were given platelet concentrates for correction of thrombocytopenia. All parameters and neurologic status were closely followed. Four of these patients had deterioration in neurologic status; 2 of them underwent surgery.
Two patients who underwent surgery had excellent outcome. One patient was managed conservatively with cerebral decongestants. Two patients with deep-seated bleed had very rapid deterioration and died.
High index of suspicion in dengue is required especially during convalescence in those patients who are disoriented and have altered sensorium. It should not be misinterpreted as fever delirium or toxic encephalopathy. It needs immediate attention and investigation. Timely diagnosis and intervention can thus save many precious lives.