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Q. Do you think the treatment given for my father is right?


 

Hi doctor,

My father, who is 58 years old, having diabetes for the last 23 years. He always takes Insulin and other sugar tablets. His weight is 67 kg and height is 5'5". For the last two months, he has been taking Aspirin 75 mg. He had a minor headache for the last few days. Also, he had a cold and cough and took Azithromycin. Six days back, some blood came out through cough and he was advised to stop Aspirin. So, he did not take Aspirin for the last five days. Yesterday, he felt nauseous and vomited continuously. He had blurred vision, felt an imbalance while standing and had severe headaches. Then, he had a CT scan and a subdural blood clot was found. CT scan report summary NCCT of the brain suggests subacute on chronic subdural hemorrhage in right cerebral convexity with mass effect. So, our neurosurgeon suggests for operation, but due to Aspirin he kept the operation on hold for four to five days. But, my father is still unconscious. He is in ICU and under observation. But, in this condition, is it right decision to keep the operation on hold? In this condition, can we move the patient by flight to another place for better treatment?


Related Questions:
Why is Aspirin given for high hemoglobin and RBC count?
What are the chances of bleeding from a sudden blow if I am on blood thinners?
What exercise precautions are needed for someone who is not on blood thinners?
 

Dr. Rajyaguru
MBBS., DNB NEUROSURGERY., FELLOW ENDOSCOPIC BRAIN AND SPINE SURGERY
Neuro Surgery, Neurology, Spine Surgery

Hi,

Welcome to icliniq.com.

  • First of all, let me tell you that the decision of holding the operation is correct. Everywhere in the world that is the standard practice. We do not operate for at least five days after stopping the Aspirin or Clopidogrel.
  • Aspirin and Clopidogrel are basically sort of blood thinners and they prevent clotting. During surgery, clotting of blood is very important. If it does not clot and continues to bleed, surgery will not be successful.
  • We do the same practice. We keep the patient under observation if the patient is sick and operate after five days. If the patient is not very sick, we discharge them and call them back after five days.
  • Regarding the transfer, he has subacute on chronic hematoma and he is unconscious, so the transfer would be very risky. Even minor trauma to his head or pressure change in flight during transfer can create major problems.
  • While he is under observation and if he deteriorates further, then doctors will operate in spite of Aspirin and we do the same.
  • But, while transfer if he deteriorates, then we cannot do anything. So, from my point of view, it is better that he continues there.

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

 
 
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