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Got Blood Clotting In Brain Due To Hypertension And Attacked With Paralysis. Required Treatment?

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Posted on Tue, 11 Dec 2012
Question: My father-in-law has got Blood clotting in brain due to Hypertension and attacked wit paralysis (right side) . He has been hospitalized and under treatment. but still no progress in his recovery.an you please tell me what is the problem?
doctor
Answered by Dr. S K Mishra (1 hour later)
Hi,

Thanks for your query.

Though you have not specified his consciousness status and size of bleed, there are very limited and debated indications of surgery in hypertensive bleed. Since you are saying it is a right sided paralysis, which means there is a left sided bleed in the brain. Left sided bleed has a poorer prognosis. So majority would not advice for any surgical intervention. Haematoma size should be more than 50 ml. Also a relatively good coma score 12 or more is managed preferably conservatively. Similarly a patient with poor coma score 7 or less is less likely to survive or likely to remain vegetative if survives. I understand your pain, but left sided hypertensive bleed is a very bad condition and patient may remain speechless and dependent even if survives. Please discuss with your treating doctor.

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
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Follow up: Dr. S K Mishra (15 minutes later)
Can you please suggest a best hospital and Doctor in Hyderabad(State: AndhraPradesh, Country: India).
Currently he has been hospitalized in Care hospital, Hyderabad.
doctor
Answered by Dr. S K Mishra (1 hour later)
Hi,

Thanks for writing back.

In private sector, “Care” is a good hospital. If you are asking about govt. sector, you can consult NIZAM’s Institute of Medical Sciences, neurology dept.

Alternatively, there are reviews written by our users about doctors in our listing, those can guide you for a better doctor. You can search for a doctor in your area. WWW.WWWW.WW
Hope this helps you.

Regards,

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. S K Mishra (6 days later)
In addition to previous discussed problem of my father-in-law :now doctors are saying like there is an increase in wbc count leading to infection. he is still in ICU due to this condition.what is happening with him, we are clueless.why so many problems are arising one after the other?Please clarify me on this.
doctor
Answered by Dr. S K Mishra (2 hours later)
Hi,
Thanks for writing back.
Infection can happen in any patient with prolonged ICU stay, despite giving best care. I have already told you about bad prognosis of such patients.A nosocomial infection, also known as a hospital-acquired infection .In the United States, the Centers for Disease Control and Prevention estimated roughly 1.7 million hospital-associated infections, from all types of microorganisms, including bacteria, combined, cause or contribute to 99,000 deaths each year. In Europe, where hospital surveys have been conducted, the category of Gram-negative infections are estimated to account for two-thirds of the 25,000 deaths each year. Nosocomial infections can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Many types are difficult to attack with antibiotics, and antibiotic resistance is spreading to Gram-negative bacteria that can infect people outside the hospital. This is something we need to accept.
Regards
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. S K Mishra (26 minutes later)
Thanks for the info doctor.But he is again put on Ventilator, and he is been given antibiotics to get rid of infection. Still how many more days will take for him to get discharged/out of danger?
doctor
Answered by Dr. S K Mishra (22 minutes later)
Hi,
As I said, many bacteria are difficult to attack with antibiotics, and antibiotic resistance is spreading to Gram-negative bacteria. Sometimes bacteria may be resistant to all known drugs. This is something we need to accept. at this stage, we cannot be sure about anything. He may come off the ventilator or we may have to face more severe consequences.
Regards


Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. S K Mishra (10 minutes later)
so still we cant say that he will be out of danger?
More consequences means?Still he is paralyzed, when can we expect him to get cured of it?
doctor
Answered by Dr. S K Mishra (3 hours later)
Hi,

Only your treating doctor can answer your first two questions. Regarding paralysis, there is no surety for recovery. Please read my first answer. Left sided hypertensive bleed is a very bad condition and patient may remain speechless and dependent (meaning paralyzed), even if survives. Please discuss with your treating doctor.

Once he gets well from the present situation, he will need more of a home care, where every single of his requirements will have to be taken care by the family.

Hope I have been able to answer your query.

Thank you.

Above answer was peer-reviewed by : Dr. Mohammed Kappan
doctor
Answered by
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Dr. S K Mishra

Spine Surgeon

Practicing since :1998

Answered : 116 Questions

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Got Blood Clotting In Brain Due To Hypertension And Attacked With Paralysis. Required Treatment?

Hi,

Thanks for your query.

Though you have not specified his consciousness status and size of bleed, there are very limited and debated indications of surgery in hypertensive bleed. Since you are saying it is a right sided paralysis, which means there is a left sided bleed in the brain. Left sided bleed has a poorer prognosis. So majority would not advice for any surgical intervention. Haematoma size should be more than 50 ml. Also a relatively good coma score 12 or more is managed preferably conservatively. Similarly a patient with poor coma score 7 or less is less likely to survive or likely to remain vegetative if survives. I understand your pain, but left sided hypertensive bleed is a very bad condition and patient may remain speechless and dependent even if survives. Please discuss with your treating doctor.

Hope I have answered your query. Let me know if I can assist you further.

Thank you.

Regards