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Hemorrhagic stroke, subarchanoid bleeding, low BP - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Average Posted in: Stroke
Answered by

General & Family Physician
Practicing since : 2009
Answered : 594 Questions
Doctor :   Hi
User :   My father-n-law had a hemorrhagic stroke with subarchanoid bleeding last week. Currently his BP is 85/43. Is this a critical sign?
Doctor :   His blood pressure is on the lower side.Is he on any hypertensives?
Doctor :   It is quite low.
User :   dont know what that is. he is in a coma level 3 and is taking dopamine
Doctor :   Ok,yes he seems to be critical.His parameters are quite low.It should be in120/80mmhg.How is his oygen levels.
User :   96
User :   heart rate is between 105-111
User :   he has a pacemaker which is set to 14
User :   it goes to 15 a few times a day
Doctor :   oxygen levels are fine.heart rate is little above normal.But since they have classified him as coma level 3
Doctor :   You seem to have moved away from chat window. kindly login for further queries.
User :   what does coma level 3 mean?
Doctor :   it means he is responding to any stimulus in a delayed manner.
Doctor :   such as on pricking him or talking to him he responds very late .Maybe just a sound or slight movement by turning head.
Doctor :   They need to get his bleed under control before his parameters return to normal.
Doctor :   When did they classify him as class 3.
User :   According to the doctors he is actually not responding to any stimulus and the only reason they are not classifying him as brain dead is becuase he is breathing
Doctor :   It seems more of class 1 if he is not responding to any stimuli.
User :   that is what a nurse said
Doctor :   They might be seeing some response otherwise they would not put in class 3.
User :   but the doctors had initially told us brain dead
User :   can you please tell me the HONEST prognosis
Doctor :   Better you speak to the treating doctor and find out the actual class he is in.But if he is in class 1 the chances are not good.But if he is class 3 there are chances of recovery but quite slow.
User :   the ECG showed some "background activity" along with cortical dysfunction and subarchanoid bleeding in addition to swelling, fracture and some intraneal bleeding
Doctor :   From how long is he in this state.
User :   8 days
Doctor :   I am sorry to say this but he seems to be critical .If he is above 24 hrs in class 3 level then there is a possibility the chances of recovery are not good. But do not loose hope.
User :   The doctors did a few "pain" tests and he did not respond at all
Doctor :   Are you there.
User :   they initially thought that there was no brainstem activity but
Doctor :   ok,
Doctor :   ok
User :   then the EEG showed some background activity
User :   not sure what that means
User :   one sec
User :   i want to get the report
User :   actually i cannot find the EEG report now but what I wrote above is basically what is said: Subarchanoid bleeding, some background abnormal arrythmia, fracture, swelling
Doctor :   Ok the only positive finding here is background activity.Less us hope for the best because he still has 10 percent chances of recovery.
Doctor :   They will have to control the swelling and bleeding as of now.
Doctor :   They are doing, but maybe you are not aware of it. It takes time.
User :   but I do not think they are doing anything to control the swelling and bleeding
User :   the only thing they are doing is giving him dopamine to regulate the blood pressure
Doctor :   ok,
User :   they told us there is nothing they can do about the hemorrhage itself - that it is too late to reverse the damage
Doctor :   You will hve to talk to the treating physician what ois the next step they are taking.
User :   they told us that there is nothing that can be done - all they are doing is trying to keep him alive due to our religious concerns - but they are not actually doing anything to treat the stroke itself.
Doctor :   It seems that he has already passed a stage of non recovery to them , since they are in a better stage to judge him than me.But i guess they would have started other treatment in the first 24 hrs.
Doctor :   If possible try to get a second opinion from another doctor who can see the patient .
Doctor :   Kindly login for further medical queries.
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