Brief Answer:
If aphasia were known to be a DIRECT CONSEQUENCE of surgery?

Detailed Answer:
Good afternoon. Based on the limited information you may find the answer slightly ambivalent, however, since I do not know the extent of the brain bleed nor extent I must wonder whether or not the brain bleed could've caused or contributed to the aphasic process because that is is certainly possible with that type of hemorrhagic stroke.

If on the other hand the patient in question did not suffer any degree of aphasia prior to the surgical repair of the intracranial bleeding then, it is very possible that surgery could've either contributed or caused damage to the dominant hemisphere's language center (left Broca's or Wernicke's region) resulting in some type of aphasia (either EXPRESSIVE- person knows what they want to say but just can't express it; RECEPTIVE- person is unable to understand what is being said but often retains the ability to speak, however, what they say makes little sense). There are other types of aphasia.

But also, one must take into consideration another possibility which is often overlooked when it comes to complications of stroke symptoms when doing neurosurgical procedures. There are times when the neurosurgical procedure itself is not the direct cause of neurological damage that appears following surgery...rather the effects of anesthesia and lowered blood pressure in a person who has either blockages in the arteries feeding the brain or some other problem that can depress cardiac function or overall blood pressure which must be kept at a certain level at all times to avoid poor perfusion of the brain.

Now, to your question on the treatment of an APHASIA no matter what the cause. Obviously, it would be nice to know the exact cause of this type of complication if possible, however, in this case...probably no matter what the cause....there are very few REVERSIBLE causes that one could identify and then, reverse when the brain has been so compromised. There is no medication that can revert the functioning of the damaged neurons whether they may have been damaged surgically or otherwise. There is also no surgical procedure that can RECONNECT any networks that have been DISCONNECTED.

I would remind all patients and their physicians that in such situations one must be fully ready to say that from a METABOLIC point view there is nothing that can be addressed or reversed such as electrolyte imbalances, oxygenation problems due to severe COPD, and then, there are the sometimes overlooked elements such as Vitamin B12 levels, Vitamin D levels, and Thyroid hormones often reflected by TSH and FT4. If the patient is male then, I always throw in a TESTOSTERONE hormonal level check since low levels in males when corrected can sometimes make dramatic improvements in alerting brain function and improving concentration, attention, and while this may not CURE aphasia....it could go a long way helping therapy accomplish its goals.

Also, check to be sure there are well controlled GLUCOSE levels which in actuality for a person recently stroked or even suffering from complications of a neurosurgical procedure...we do not necessarily look at blood sugar levels the same way as if we were trying to control DIABETES. For the acute period of consolidation and/or rehabilitation I never tightly control blood glucose levels below about 150 and let them ride a bit high for the first few weeks or few months. The same can be said for HIGHLY RESTRICTIVE parameters on blood pressure. Following strokes or other damage to the brain...I often allow BP's to ride a bit on the higher side as well for a period of time before trying to bring the patient back down to what would be considered "normal" or "acceptable" levels.

Finally, has there been a URINALYSIS done recently? Again, this is not a high percentage test or treatment to expect reversal of aphasia if in fact due to a surgical complication, however, if a person is suffering from a urinary tract infection and this goes undetected then, neurological defects such as aphasia merely become magnified and more resistant to offered interventions or therapies.

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This query has utilized a total of 30 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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