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Brain injury - Prognosis - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Very Good Posted in: Brain and Spine
Answered by

General & Family Physician
Practicing since : 2009
Answered : 595 Questions
Doctor :   Hi
Doctor :  
How can I help you?
Doctor :   It seems you have moved out of the chat window. Please login if you have medical queries
User :   my father has met with an accident and is in coma since the 21st april09
Doctor :   Ok
User :   till date he is not counsoius ......what can been done
Doctor :   Ok, I would like to know more details about the injury
Doctor :   What is the CT scan report done immediately
Doctor :   what is done yet and what are the subsequent CT reports
User :   he had head injury and the there are many small .....blood closts ,...which the local doctors said cannot be operated ...
Doctor :   Ok
User :   blood clots..CT report ..was done
Doctor :   Can you type out the CT scan impression
Doctor :   first one
User :   that is not possible to do that
Doctor :   I wanted the CT scan impression so that the discussion is simple and concise
Doctor :   and is understandable to you
User :   there is skull facture ......
Doctor :   ok
User :   contursion measuring 1.8cms noted in L frontal region in the perisylrian location. sub centeric conturions also noted in the rt frontal and lf periotal region
Doctor :   Ok there are multiple contusions
User :   SAM noted in the Lt temporal region with blood lt sylvian fissure
Doctor :Is it subarachnoid mass (SAM)
User :   obliteration of the cortical sulon noted in the lt cerebral hemisphere s/o cerebral edema
User :   SMA i think so
Doctor :Ok
User :   pockets of air noted in the rt temporal and occipital region s/o prieumocaphalus
Doctor :If the injury has Skull fracuture it is relatively good and the person has the scope to improve
User :   no c/o midline shift
Doctor :If there is no midline shift then it is a good sign
Doctor :WHat is the age
User :   vantricular system D
User :   65 years
Doctor :   How are BP, Pulse now
User :   facture noted in the rt tamporal bone extrenal to the mestoid bone with blood in R mastois aircells
Doctor :   Ok
User :   the BP and pulse and in control .....within range ......being given losar 50 mg and 6-6-4 units of insulin for sugar
User :   scalp haetoma in rt parietal region with hypsderm within s/o foreign body
User :   GCS = E4M5V1
Doctor :Ok
User :   can have some feed back now
User :   hi
Doctor :Yes
Doctor :I shall give you my opinion on this now
Doctor :With old age, GCS score moderately poor, with multiple contusions, no midline shift I would say the recovery takes time
Doctor :The time cannot be predicted subjectively
User :   still ...some time frame .....
User :   what are the chances ...for the recovery
Doctor :   The time frame cannot be told online for the reason, I do not how clinically he is progressing, what is his motor response, what is BP, cranial BP. His respiratory parametres like
Doctor :   PaO2
User :   i am not sure ...ok thanks
Doctor :   Since the age is old, the prognosis is poor
Doctor :   But I can help you in some other way
Doctor :   If you can keep informing me about the said parametres
Doctor :   by knowing from the doctors
Doctor :   and knowing me
Doctor :   I can assess the time frame
Doctor :   Ok.
Doctor :   Did you follow?
Doctor :   I have to close the window as you are not responding me. Please login if you have further medical queries.
User :   ok
User :   what is Pao2
Doctor :   it is partial pressure of oxygen
User :   oxygen level as long as they were measured between 90% to 98%
User :   how is the Pao2 measured
Doctor :it is done by either Arterial Blood Gas sample or by the probe which is put in the fingers
Doctor :   did you follow?
Doctor :are you with me?
Doctor :   I have to close this window since there is no response from your side, we are available 24/7 please get back to us if you need further medical advice.
Doctor :   are you back?
User :   yes
User :   there was a probe put on the finger for BP / O2 levels
User :   The edema in the brain has reduced
User :   he is moving his LT hand and both legs ...except the rt hand
Doctor :   ok
Doctor :   is the eye movements pesent
Doctor :   I mean spontaneous eye movements?
User :   opens his eyes .....and moves them ........yes
Doctor :ok
Doctor :this is a good sign
User :   his puplis also react to the light ......and are not pin point
Doctor :   ko
Doctor :   this is also a good sign
Doctor :   plz tell me the treatment that the doctors are following at present
User :   feed is through nasal pipe ....... he does not spk verbal communication
Doctor :   ok
Doctor :   plz tell me the treatment that the doctors are following at present
User :   he is being given Fursium 10mg 1-0-1
User :   losar 50mg 1-0-0
User :   bachof 10 mg 1-0-1
User :   insulin 4-6-6 units
User :   some vitamins
Doctor :   ok
Doctor :any injectables?
User :   how does the picture look now
User :   none ......
Doctor :ok
Doctor :he seems to be ok, but will he recover or not from here is really difficult to predict
User :   but what other treatment can been done the recovery to happen there some other treatment that can be given
Doctor :   in my opinion the best treatment is given, all he needs is the close monitoring and prevention from any of the infections
User :   sir though i have discussed the case ...i need to know if u are a neuorologist or a neuro surgeon ........what is you qualification
Doctor :   I am a General Practitioner
User :   based in where ? ...mumbai?
Doctor :   Bangalore
User :   ok ...... do you think i should consult any other specialist doctor who will be able to give any new treatment...
User :   any consultant in mumbai whom i can show the CT scans etc and who can help me?
Doctor :   treatment line is more or less similar, so no need to consider in my opinion. but if you want to take second opinion than you can consider a Neurophysician
User :   any doctore recommended
Doctor :   No particular doctor as such
Doctor :   but you can consult any neurophysician
User :   ok thanks
Doctor :is there anything else i can help you with?
User :   no thanks
Doctor :   Please fill the feedback form
Doctor :   Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.
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