cerebellar hemorrhage with rapidly evolving deep coma

[tarek]

45 year old male previously healthy. Develops vomitting at 1.45 a.m. and lapses into deepening coma. At emergency reception in top University Hospital it is said he became apneic and lost brain stem reflexes. CT showed large cerebellar hemorrage invading the ventricles. Neurosurgeons consulted hours later as coma deepens said that his condition was hopeless and Glasgow coma scale at 3 was contraindication to any interference. It is not clear what measures were taken to keep him ventilated during ct scan. How do you scan a patient in deep coma with apnoea still allowing vital brain oxygenation? Also I feel there should be a clear diffirence between GCS in relation to a young patient with coma of know removable cause in evolution and old patient with static established non-responsive coma, could you confirm or negate this idea? Is the Glasgow coma scale as assessed by a lone junior doctor an irrefutable and final tyrant or are there other factors to take into consideration Therefor should a patient like that undergo immediate decompression or be left alone i.e. condemned to die of brain stem compression.