Brief Answer: Nursing, CT scan/MRI, intensive care, nursing. Detailed Answer: Hi and thanks for the query, A rapid diagnosis and appropriate initial treatment a key factors in ensuring rapid getting back to form and avoiding complications. There are many conditions that could cause brain bleeding. However, some key issues related to your sister's medical history are important. Its important to know if she had high blood pressure or not, and in case yes, if she was compliant to treatment. Poorly controlled high blood pressure can cause bleeding in the brain. A family history of brain bleeds would also be important to be noted. Brain malformations and aneurysms (abnormally dilated regions of blood vessels) can rupture and also cause bleeding. A notion of any trauma should be noted. Some people can have trauma and bleed gradually, while symptoms are not noted immediately, but only get clear when a substantial amount of blood must have leaked out. Certain drugs ca cause bleeding, so her drug history is also important. Left poorly managed, many complications can arise. Apart from paralysis one parts of the body, speech loss, other complications like depression and dependence on others for basic activities can arise. Depending on the extent of the bleeding, increased pressure in the brain can cause death. Dementia is also a very common complication seen in these patients. Chronic headaches and seizures are observed in some patients. Treatment has various aspects, and is specific depending on the cause. A CT scan and MRI are very vital during this process. Nursing, keeping the patient warm and proper control of her blood pressure are very important. Avoiding drugs that can cause bleeding is important. A proper management of the fluids given to her, ensuring she has a good oxygen supply, preferably in an intensive care unit, especially during the first days is important. Mobilizing the lady frequently to avoid bed sores is important. based on the extent of the bleeding, surgery can be recommended in some situations. Physiotherapy prevents muscle loss (atrophy) and accelerates rate o starting normal daily activities. I suggest she be transferred to a special neurology service. Compliance to treatment at this point is very vital, especially is he is hypertensive. Kind regards as I wish you the best of health. Dr Bain

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