What are the ways to manage a comatose patient?

Question

Hi doctor,

My father had a pons hemorrhage five months ago, and the hematoma has dissolved. He opens his eyes sometimes but moves his eyes upward and downward only, and the rest of the body is in locked-in stage. He moves his left arm sometimes but does not follow a command. His GCS (Glasgow Coma Scale) is E4V1M3.Tracheostomy is also done. He was removed from the ventilator and oxygen as his vitals were normal. The new report shows late subacute intraparenchymal hemorrhage involving the pons with hyperdense attenuation. The lesion is about 0.74 x 0.47 x 0.43 inches in size. There is minimal perilesional edema with hypodense attenuation. It also shows relatively old lacunar infarcts involving the coronae radiata, centrum semiovale, and the basal ganglia bilaterally with mild hypertensive and ischemic white matter changes. Are there any medications to get his memory and consciousness back? Kindly suggest.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern. The neurologic findings that you described have caused permanent damage to the brain. Most stroke improvement will occur within six weeks to three months after the event. However, recovery for such patients who cannot communicate and function normally has been very rare. There is no specific medicine that will help recover brain function. Monitoring and controlling his blood pressure is important to reduce the risk of further stroke. Since what he had was bleeding, he should not be placed on any blood thinners or the tablet Aspirin. I hope this helps you.

Thank you.

What are the ways to manage a comatose patient?

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