Hi doctor,
My father is 55 years old. He is good in terms of his health and weight. He recently had a large AVM rupture and he was flown to the nearest hospital. He had a craniotomy to remove AVM and the ICH caused a large stroke. He was left paralyzed on his right side with the capability to speak, but limited. He says a few words here and there, but mostly mumbles or says things that do not fit the context of the present. He is in a rehabilitation where they are supposed to be helping him with this now. My concern is that recently he keeps having the episodes of losing consciousness. For a few times it happened for about 10 minutes and today for over an hour. He was calm and sitting up. He laid back down slowly (with my help, of course) and all of a sudden would not wake up. His vitals were fine though they had put him on oxygen this afternoon, because it was a little low (high 70's and low 80's). He was on it when this occurred. Is there any indication as to why this is happening? He has been sent to the emergency room for it a bunch of times, but each time they send him back after doing a CAT scan. By the time he would see the doctor, he would be awake.
Recently, his medication was changed from Keppra to Lamictal. He has been experiencing a bit of tremors as well and I am not sure if it is the new medicine. They will be scheduling him for a neurologist appointment and an MRI in the upcoming week. Do you have an idea as to why these unconsciousness occurs? He communicates sometimes by saying yes or no, but it is inconsistent. He goes in little stages of being combative, calm, sleeping, aggressive and then basically aware. Could this unconsciousness be one of these? I seem to be the only one extremely concerned about them, but he has not seen a neurologist about it. Please help me.
Hi,
Welcome to icliniq.com.
- When the cortical damage is widespread, the consciousness is impaired.
- Your father has come out from the deep unconsciousness, he is recovering now. During recovery, this sort of episodes are common and gradually the frequency of this episode would come down.
- Other factors like hydrocephalus or rebleed can make him drowsy, but those things have been already ruled out by CAT scan.
- Drop in oxygen saturation may be because of reduced respiratory drive (if the lungs are normal), if you wake him up and ask him to take a deep breath, it may improve just with that.
- The behavioral changes, which you observe, would improve over a period of time.
- Apart from the brain dysfunction, his low blood sodium can make him drowsy. I am sure when you went to the emergency room, your doctors would have checked it.
For further information consult a neuro surgeon online --> https://www.icliniq.com/ask-a-doctor-online/neuro-surgeon
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