Why would the brain stem swell after a heart attack? pt. down for 20 min before ems arrived, heart shocked 4 times by ems. pt. sedated for 24 hours sedation removed but b/p shot up and was sedated another 24 hours. vent was turned down pt in coma?

I would expect cerebral edema in this unfortunate scenario. I also expect the edema would involve the cerebral cortex as well as the brain stem. Needless to say recovery of more brain function is very unlikely the longer the coma lasts.

It has to do with the time the brain has not been perfused and suffered from the lack of oxygen. That is the cause for the swelling or edema. While hoping for the best would prepare for all possibilities.

Brain tends to respond to many insults with swelling/edema. Anoxia from heart attack is one form of insult, low levels of sodium in blood, infection in the brain. and sometimes even minor trauma to the brain can result in serious swelling.