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Left cerebral infarction,unconsciousness,stroke?

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General & Family Physician
Practicing since : 2004
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Hello, my husband died 48 hours after suffering a left hemisphere cerebral infarct. He was unconscious when I found him, he looked like he was sleeping, quite peaceful. When we arrived at the hospital theyy did a CT Scan and then admitted him to ICU. They discussed a operation at one point but ruled it out as his quality of life would not have been good. No other treatment was administered. Was the stroke so XXXXXXX that treatment was not an option or was it because he did not arrive at the hospital within 3 hours of having a stroke.
Posted Fri, 27 Apr 2012 in Stroke
Answered by Dr. Chakravarthy Mazumdar 3 hours later

I am sorry for what had happened to you recently. I know it takes sometime for you to recover after the loss of your husband.

The causes of death after cerebral infarct can be explained thus:
1) The most frequent cause of death after cerebral infarction is transtentorial herniation, followed in frequency by pneumonia, cardiac causes, and pulmonary embolism. 36% of all patients and 47% of those with transtentorial herniation died within 48 hours of cerebral infarction.
2) The other important reason, strokes occur because of atherosclerosis in the cerebral arteries which can indirectly indicate a cardiac cause (heart problem). So generally doctors while treating stroke should also evaluate for cardiac disease and treat it simultaneously.

Why was surgery or no other option left?
1) Your husband might have suffered an infarct which was involving the higher and most important centers of brain as seen on CT scan. The doctors should have felt that it would was a futile attempt to rush to Operating Room. Instead a medical management could help.
2) Second thing was the general condition of your husband deteriorated by the the time you reached hospital ( he was unconscious at home because of massive stroke). This did not permit anesthesia.
3) Generally it is advised a 3 hour door time to receive thrombolytics in cerebral infarcts. The administration of thrombolytics is not helpful after 3 hours.

Hope it answers few of your questions. I am available for any follow ups.

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