Doctor insights on:
Coma After Stroke
66yr/ m congestive heart failure, stroke, pulmonary embolism, then 2nd massive hemorrhagic stroke, surgery to repair, fell into coma. prognosis?
Elderly lady had stroke due to blood clot. Has brain swelling. In a coma. Stroke induced. Chances of survival?
Generally not: It depends on the specific situation, but if the brain has been deprived of oxygen for more than 12 to 14 minutes, the damage is (usually) at least partly irreversible. A relatively new technique called therapeutic hypothermia improves the statistics somewhat, but the outcomes for many patients are still poor. ...Read moreSee 1 more doctor answer
Size of stroke: The amount of swelling, or edema, around a stroke is related to the volume of tissue infarcted. For a small stroke, swelling shouldn't be a problem. For a major hemispheric stroke, swelling can be life threatening and even sometimes require brain surgery to relieve pressure caused by the swelling. ...Read moreSee 1 more doctor answer
Not usually: Most of the damage from a stroke occurs right away. Almost always there is some recovery. Contractures and spasticity secondary to strokes can worsen over time, but usually stabilizes after one year. Obviously if you have had one stroke, you can always have another stroke which can make things worse. ...Read more
Acute hypertension: The short answer is no. Acute severe hypertension may lead to a stroke, but usually does not. If there is an underlying vascular malformation or aneurysm, there may be a hemorrhage, but these are not common. Chronic untreated hypertension produces changes that increase the risk of stroke, so treating it to keep systolic pressures at or under 130 is advisable. Work with your family doctor. ...Read moreSee 1 more doctor answer
Possible: Subdural hematomas can sometimes rebleed. If the new episode of bleeding is large enough it can cause pressure on the brain and new symptoms. ...Read more
63yodad ischemic stroke 2wks ago. Before had a DVT & asymptomatic brain aneurysm. @risk for falls from motor control issues. Should he start coumadin (warfarin)?
Risk / benefit tool?: Secondary Prevention of Stroke is important in reducing risk of recurrent stroke and potentially severe disability. Warfarin is indicated in Secondary Prevention if the patient has a diagnosis of Atrial Fibrillation. CHA2DS2-VASc and the HASBLED Scores at www.mdcalc.com can give some objective measure to help patient in discussion with doctor assess risk / benefit of anti-coagulation. A guide only ...Read moreSee 2 more doctor answers
In some cases: It depends on the nature of the injury and specific symptoms. There are certain situations when patching one eye or using special prism glasses may be of benefit as well as other therapeutic techniques. However, it is always best to be evaluated by a specialist to best assess what makes the most clinical sense for each individual. ...Read moreSee 1 more doctor answer
When someone is resuscitated after cardiac arrest, is consciousness regained immediately? Or could it take any longer?
Usually not....: after someone suffers cardiac arrest, resuscitation is attempted. If successful, the person usually does not regain consciousness immediately. It usually takes time for the person to wake up and the amount of time it takes is very variable. It's not like what you see on tv or in the movies!!!! ...Read more
Brain stroke recovered,suddenly ammonmia up 99mgc/dl, encephalopathy,motion3times, still unconscious,bp very low, giving saline sol to maintain,advice?
Sounds VERY: serious. If arterial ammonia is elevated, then probably means liver failure. Causes of low blood pressure are many, but if IV saline is correcting it, it sounds like dehydration. If he has sepsis (causing low BP), infection needs to be treated. Consult with a liver specialist. ...Read more
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