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What Causes Stroke In A Healthy Active Person?
Question: My grandpa suffered a stroke last Saturday (11/15/14). He was alert when it happened but could not open his eyes. He threw up. He lost function of the left side of his body. In the hospital he spoke to my uncle and told him to call my mother and told him where exactly the phone book was so he showed signs of good brain function. He doesn't comprehend that he is in the hospital and tells my uncle that if he is indeed in the hospital then they will "destroy him" which is what he used to say all the time when he was a-okay. He has trouble swallowing so they feed him through a tube. Last night (11/16/14) the doctor said he stopped breathing on his own so the machine is currently breathing for him. I want to know your medical opinion as to why my grandpa went from being alert (just had eyes closed and had trouble speaking correctly) to now not breathing on his own. Please respond as soon as possible-I appreciate it so very much.
Brief Answer:
clinical worsening due to secondary brain damage
Detailed Answer:
Hello, I have gone through your question and understand your concern.
Stroke is a very serious and life threatening condition, which I suppose you have already been informed. As I can read from the symptoms described, involving the left extremities and swelling, the stroke involves a vast area of the brain or more probably a very delicate structure called truncus cerebri, the lower part of it, called medulla oblongata.
After suffering the stroke causing the symptoms you described due to infarct of that area responsible of the first symptoms (left hemiplegia, confusion, difficulties on swelling) there is some reaction of the surrounding brain structures called edema (basically a swelling) which compress the normal structures responsible for consciousness and breathing, which being under pressure suffer from hypoxia and can lead to infarction of these areas. There are some treatment to prevent this eventuality but not always effective, which seems happening in this case, leading to potentially fatal condition.
Hope I answered your question, please feel free for further questions.
clinical worsening due to secondary brain damage
Detailed Answer:
Hello, I have gone through your question and understand your concern.
Stroke is a very serious and life threatening condition, which I suppose you have already been informed. As I can read from the symptoms described, involving the left extremities and swelling, the stroke involves a vast area of the brain or more probably a very delicate structure called truncus cerebri, the lower part of it, called medulla oblongata.
After suffering the stroke causing the symptoms you described due to infarct of that area responsible of the first symptoms (left hemiplegia, confusion, difficulties on swelling) there is some reaction of the surrounding brain structures called edema (basically a swelling) which compress the normal structures responsible for consciousness and breathing, which being under pressure suffer from hypoxia and can lead to infarction of these areas. There are some treatment to prevent this eventuality but not always effective, which seems happening in this case, leading to potentially fatal condition.
Hope I answered your question, please feel free for further questions.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
What is your prognosis on his life? Does this appear to be a sign that things are only getting worse? What are the chances of him getting out of the coma and if he were to get out of it, how would his recovery look like?
Brief Answer:
Reserved prognosis
Detailed Answer:
This is a difficult question. In this stage you can not predict for sure the clinical course, because the response is not the same in different patients. That is why the term "reserved prognosis" is used. For sure it is a critical condition. There is some chance that your grandfather recovers from the secondary brain damages, explained before. In this case an MRI would help in defining if the stroke are is extended or not. But he can not perform in this moment because of the mechanical respiration.
Unfortunately most of these cases have a bad prognosis, which worsen further or remains stable, with the permanent mecanical respiration. I am assuming that the stroke involved the medulla oblongata. Otherwise there is a slighter better prognosis if the stroje involved the cerebral hemisphere. Still, unfortunatelly, at this moment this is a critical condition. Wishing your grandfather recovers, hope this answers your question.
Reserved prognosis
Detailed Answer:
This is a difficult question. In this stage you can not predict for sure the clinical course, because the response is not the same in different patients. That is why the term "reserved prognosis" is used. For sure it is a critical condition. There is some chance that your grandfather recovers from the secondary brain damages, explained before. In this case an MRI would help in defining if the stroke are is extended or not. But he can not perform in this moment because of the mechanical respiration.
Unfortunately most of these cases have a bad prognosis, which worsen further or remains stable, with the permanent mecanical respiration. I am assuming that the stroke involved the medulla oblongata. Otherwise there is a slighter better prognosis if the stroje involved the cerebral hemisphere. Still, unfortunatelly, at this moment this is a critical condition. Wishing your grandfather recovers, hope this answers your question.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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