How is stroke paralysis managed when someone is in a coma?

Question

Hello doctor,

One of my close friend has suffered a heart attack yesterday. He has gone into a coma. One side is paralytic. We are trying to seek advice as to whether we can do something more for him. I can attach the MRI brain report. The doctors have kept him in the ICU for 72 hours of observation.

Please suggest if something can be done.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

From your description and the MRI report, it is quite clear that the patient is suffering from what is commonly known as a brain stroke (attachment removed to protect patient identity). It occurs when part of the brain loses its blood supply and the brain cells of this area die out, resulting in loss of function of the affected area, like consciousness, speech, movement (paralysis), etc.

My hospital has several patients of the same type every day. In most cases, it is a recoverable condition, albeit sometimes the recovery may be very slow and sometimes incomplete. The most dreaded effect of the stroke is the loss of respiratory function, as in that case, the patient would die immediately. Hence, the 72-hour observation in the ICU (intensive care unit) is a sensible choice.

Is there anything more you can do for him? Yes, of course. While the doctors and nurses are trying to do their best for the patient, there are quite a few things that you can do to help this family. Foremost is to explain to the patient's family that his recovery may be slow and there is nothing to lose heart.

Secondly, the family members should refrain from trying to enter the ICU too often to see him. It may cause an infection in the patient at this vulnerable stage. After the patient comes out of the ICU, depending on the facilities available at the hospital, the semi-conscious or unconscious patient must receive full hygienic care, like cleaning the mouth and teeth, eyes, ears, and private areas at least thrice daily.

If the patient is fed through a nasal tube, the head-end of the bed is to be raised during the feeding process and upto about 15 minutes afterwards. In many cases, these may be done by the nursing staff, so you do not have to worry.

Overall, in the immediate present stage, it is mostly a matter of waiting for the treatment to succeed, comforting the family, and following the advice of the doctor.

I hope this helps.

Thank you.