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Hello Dr, My Father Is 77 Yrs Old And Generally
Question: Hello Dr,
My father is 77 yrs old and generally up until last Friday was hail and hearty with no major health issue except he is hypertensive. Last Saturday, we found that he had a moderate bleeding in his brain possibly due to blood vessel rupture. He is in ICU still and 2nd CT showed no more increase with hemorrhage and of course physically symptoms of slurred speech and loss of balance is there but he has shown improvement since Friday and is mentally active, with active limb movement but restricted walking which happens with assistance . My question is mainly reg to treatment course, the hospital where he is, has suggested no intervention with the hemorrhage(the blood clot will clean up and brain will repair)but strongly advised BP control and I am trying to understand if there are other treatments possible. I am attaching last two CT Scans from Saturday and Sunday. Thank you for your help.
My father is 77 yrs old and generally up until last Friday was hail and hearty with no major health issue except he is hypertensive. Last Saturday, we found that he had a moderate bleeding in his brain possibly due to blood vessel rupture. He is in ICU still and 2nd CT showed no more increase with hemorrhage and of course physically symptoms of slurred speech and loss of balance is there but he has shown improvement since Friday and is mentally active, with active limb movement but restricted walking which happens with assistance . My question is mainly reg to treatment course, the hospital where he is, has suggested no intervention with the hemorrhage(the blood clot will clean up and brain will repair)but strongly advised BP control and I am trying to understand if there are other treatments possible. I am attaching last two CT Scans from Saturday and Sunday. Thank you for your help.
Brief Answer:
The condition seems stable for now.
Detailed Answer:
Hello and welcome to "Ask a Doctor " service.
I have read your query and here is my advice.
I examined the two CT scans that you uploaded.
The hemorrhage is located deep in the cerebellum near fourth ventricle and seems stable after the second CT scan.
I agree with the course of the treatment for now, there is no indication for surgery right now and a normal blood pressure is necessary to be maintained in order to prevent any other hemorrhage or current hemorrhage expansion.
Bit, there is still need for a close medical observation because there is a risk of increased intracranial pressure since the swelling around the hemorrhage may compress the fourth ventricle.
In such setting a neurological deterioration may happen and neurosurgical intervention ( diversion of cerebrospinal fluid with or without hematoma evacuation ) may be necessary ASAP.
Discuss with the Neurologist and the Neurosurgeon in charge for these issues.
Hope you found the answer helpful.
Let me know if I can assist you further.
The condition seems stable for now.
Detailed Answer:
Hello and welcome to "Ask a Doctor " service.
I have read your query and here is my advice.
I examined the two CT scans that you uploaded.
The hemorrhage is located deep in the cerebellum near fourth ventricle and seems stable after the second CT scan.
I agree with the course of the treatment for now, there is no indication for surgery right now and a normal blood pressure is necessary to be maintained in order to prevent any other hemorrhage or current hemorrhage expansion.
Bit, there is still need for a close medical observation because there is a risk of increased intracranial pressure since the swelling around the hemorrhage may compress the fourth ventricle.
In such setting a neurological deterioration may happen and neurosurgical intervention ( diversion of cerebrospinal fluid with or without hematoma evacuation ) may be necessary ASAP.
Discuss with the Neurologist and the Neurosurgeon in charge for these issues.
Hope you found the answer helpful.
Let me know if I can assist you further.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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