Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
125 Doctors are Online

Left hemisphere cerebral infarct, massive stroke, incontinent, CT Scan

User rating for this question
Very Good
Answered by

ENT Specialist
Practicing since : 1991
Answered : 2551 Questions
Hello, m husband died from a left hemisphere cerebral infarct. He had felt poorly during the night and was sick. I left him to sleep and went to work. When I found him that afternoon (about 4pm) he looked like he was sleeping. I tried to rouse him and he half opened his eyes, moved his left arm to his head then went back to sleep. He was also incontinent. I called a ambulance and he was taken to the local accident and emergency dept. They did a CT Scan and within 20 mins of being there they told me that he had a massive stroke and there was talk of an operation at another hospital 40 mins away. They then decided that this was not appropriate as his quality of life would not be good. He was taken to the ICU and was just given fluids. Could you explain why no other course of treatment was offered. He died the following afternoon at 3.30 without gaining consciousness. He did squeeze our hands and try and open his eyes during the evening he was in ICU, is this still a state of unconsciousness?
Mon, 21 May 2012 in Brain and Spine
Answered by Dr. Sumit Bhatti 4 hours later

Please accept our heartfelt condolence.

A massive (also known as 'malignant') infarction in the dominant brain hemisphere is associated with a very high mortality rate.

His Glasgow Coma Scale (GCS) must have been very low on admission, since he passed away within a day. Besides the GCS, many other factors are important, such as midline shift, additional areas or vascular territories of infarction, level of consciousness, pupillary light reflex and such other parameters which were known only to his caregivers at that time. Most craniotomy operations are done over a longer timeline.

There is no significance of the delay in reaching the hospital. In such a massive stroke-in-evolution, the CT / MRI findings may be relatively normal in the initial few hours. The true picture may emerge many hours later as the intra cranial pressure keeps increasing due to venous blood outflow being blocked by the rising brain edema (swelling) secondary to the infarct. Once the sequence of events in massive infarction unfolds, it does not usually respond to any conservative medical or aggressive surgical treatment.

Gripping a hand or opening eyes may only be a primitive or spinal reflexs. There may be no vision. These signs in the absence of consciousness have no prognostic value.

Hope I have answered some of your questions.

Above answer was peer-reviewed by
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions

The user accepted the expert's answer

Ask a Neurologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor