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Got brain injury after an accident. On ventilator. Undergone leg surgery. Noticed fluctuating GCS. On medication

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Neurologist, Surgical
Practicing since : 1996
Answered : 146 Questions
Myself XXXXXX Son Of Patient XXXXXX(Father)
Sir On 15-03-2013 Morning 7:30 Am He Injured In An Accident After That Ambulance Takes Them To Local Govt.Hospital They Give First Aid And Recomend To Go Outside From Mansa.Then We planTo Go At XXXXXXX Bathinda.They Do CT Scan On Same Day After They Say They Get Injured In Right Side Of Brain And XXXXXXX Bleeding To They Are Not Any Movement In Body Of My Father.Then Next Three Days They Put Them on Ventilator And Sedation Too.Afterwards They Do CT Scan Again Report Was Attached This Mail Some Kind Of Movement Starts Like mOving Legs And Hands In Mean Time Three Leg Surgries Done By Ms Ortho.Slowly Slowly They Open Eyes For A Seconds And Now After 14 Days They Dont Resond Too much He Opens Eyes At Pain Or Automatically For Few Mins 3-7 Mins.In Mean Time From Day 5th He Is On Trichosmy And Ven.Going on But Today From two Days Back Is On Room Air &T-Pep Mode In Daytime In Night On Venti For Few Hours Because Of ABG Report.Main Thing GCS Csore On Day 1 Is 2 But On Day 10 Is 9-10 But Today Is 8 From Two Days .There Is No Recovory From Last Three Four Days.So We Worried A Lots We Belive heathcare magic can help us were nor in position to shift or move.My ques are as follow:-
1-Sir Please Tell Us Is My Dad Will Recovers Properly & XXXXXXX Time To Wake Up Properly.
2-Is Treatment Is porper going On 7 On Recovery Side Acc to You.
3.Sir am Alone please Tell me xact position of dad
4.When will he open eyes and speak.
Medicine acc to doc goin on are antibiotics muli vitamins and epition
Posted Tue, 16 Apr 2013 in Stroke
Answered by Dr. Praveen K Nath 1 hour later

At first, my best wishes for a speedy and complete recovery to your father.

I have gone through your father's detailed report including the CT scans dated 15 and 18th March. The scans reveal that he has a left basifrontal & perisylvian contusion with subarachnoid hemorrhage. Such patients are managed conservatively with ventilation and supportive case as it is done in your father's case.

Brain injuries such as these are unpredictable. Therefore the recovery period is unpredictable. However in your father's case, he seems to be recovering. Fluctuating GCS in these patients is a known thing. My suggestion would be

1. Get MRI brain to rule out diffuse axonal injury of the brain. Discuss with his treating doctor if MRI is feasible at this point of time.
2. Maintenance of proper oxygenation level (checked with blood gas analysis) - to be done regularly
3. Regular physiotherapy & tracheostomy care is must
4. Treatment for these types of cases is standard at most of the places & same as being given to your father.
5. There is no time frame to recovery for this type of patient. Brain recovery takes longer time.

Hope this answers most of your queries. Let me know if you have other queries.

Good luck

Dr. Praveen K Nath XXXXXXX Consultant Neurosurgeon
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