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Q. Is there a possibility to perform MRI of brain when on ventilator?

Answered by
Dr. Lalit Bansal
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 26, 2017 and last reviewed on: Aug 31, 2021

Hi doctor,

My mother is 65 years old. She is suffering from high blood pressure and high sugar levels. As a result of this, she fell unconscious and her brain has some small blockages and damages. Please help.

#

Hi,

Welcome to icliniq.com.

I examined the CT scan report (attachment removed to protect patient identity) and clinical assessment. My findings are:

  • On CT scan, I noticed that your mother had 5x4 cm infarct (stroke). The reason for her to fall unconscious might be because of nonconvulsive status epilepticus or coma.
  • EEG (electroencephalogram) test will confirm, if she has ongoing seizures or not. Also, it will help in optimizing her anti-seizure medications. 
  • Through CT scan nothing much can be known about acute stroke. Hence, I would suggest you to get an MRI of brain done. It will help in detecting edema and other areas of stroke if affected.

Guidelines for stroke management;

  • Lower the BP (blood pressure) by maintaining systolic above 160 mmHg for proper perfusion of brain.
  • Maintain normal blood sugar level.
  • If lipid levels have increased, medications need to be started.
  • ECG (electrocardiogram) is advised to check for presence of any emboli or growth in heart.
  • TSH (thyroid stimulating hormone) or FT4 (free T4). Either of these thyroid function tests needs to be performed.
  • If there is clotting associated with it, then tablet Aspirin needs to be administered.
  • Repeat the CT scan from the day of stroke for a period of three to five days.
  • EEG (electroencephalogram) needs to be performed to rule out non-convulsive status epilepticus.
  • Physical therapy should be provided.
  • If unconsciousness is due to brain edema, it should get better after five days post- stroke, and you may see a change. 
  • Her GCS (Glasgow coma scale) is very low. It is usually associated with poor prognosis.

For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Hello doctor,

She is now on ventilator. I want to know, is MRI brain possible now? How to save her? Please, doctor says it may be possible that blood not reaches to brain or anything else but without MRI brain what can we do? Kindly suggest.

#

Hi,

Welcome back to icliniq.com.

Without examining the patient, it is difficult to give assessment and treatment plan. I think if she is worsening, then repeating a CT of head would be wise, to make sure there is no herniation or worsening edema in brain or any bleeding present. 

For further queries consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist


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