Patient's Query
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 computed tomography (CT) scan report (attachment removed to protect patient identity) and clinical assessment. My findings are: On CT scan, I noticed that your mother had1.97x1.57 inch 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 magnetic resonance imaging (MRI) of braindone. It will help in detecting edema and other areas of stroke if affected. 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 computed tomography (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. Guidelines for stroke management;
Patient's Query
Hello doctor,
She is now on ventilator. I want to know, is magnetic resonance imaging (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 computed tomography (CT) of head would be wise, to make sure there is no herniation or worsening edema in brain or any bleeding present.
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Answered byDr. Lalit R. Bansal
Medically reviewed byiCliniq medical review team
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