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Stroke, Persistent Vegetative State, Brain Stopped Functioning, MRI, EEG, Improvement In Eyelid

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Posted on Sat, 19 May 2012
Question: My grand uncle had a stroke (heart attack) on Feb 6th. Since then he’s gone into a persistent vegetative state with no limb movements. The doctors are of the opinion that his brain has stopped functioning while his other vital organs are functioning. There is little if any movement in his eye-lids and sometimes feet but otherwise he does not respond to any calls.

I am attaching his case summary along with MRI and EEG from the hospital. I would request you (a neurologist) to let me know if there are any chances of revival.
doctor
Answered by Dr. Shivakumar S. Kupanur (2 days later)
Hello.

Thanks for posting your query.

I have gone through the reports provided by you. Based on that, it's quite clear that he had hypoxic brain injury possibly due to cardiac event.
MRI brain and EEG also support findings of partial ischemic brain injury.

His current treatment is on right guidelines.

It is very difficult to predict the chances of revival now. He needs periodic neurological assessment. Most often they may develop further complications like aspiration pneumonitis, chest infection, hypotension (low BP), etc. It is of major concern now and needs to be handled carefull.

Some patients if the brain stem is intact and other areas are partially intact, they remain in persistent vegetative state for log time. Gradually, he may show some improvement with supportive treatment. But, it cannot be predicted at this stage. You need to have lot of patience.

I suggest weaning him from ventilator and to go ahead with tracheostomy. Continue nursing care and physiotherapy. Drugs which can make him alert can be tried like Citicoline, Cognistar, etc.

I hope, I have answered your query to your satisfaction. I am available to address any other concerns that you might have.

Regards
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Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Shivakumar S. Kupanur

Neurologist, Surgical

Practicing since :1997

Answered : 65 Questions

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Stroke, Persistent Vegetative State, Brain Stopped Functioning, MRI, EEG, Improvement In Eyelid

Hello.

Thanks for posting your query.

I have gone through the reports provided by you. Based on that, it's quite clear that he had hypoxic brain injury possibly due to cardiac event.
MRI brain and EEG also support findings of partial ischemic brain injury.

His current treatment is on right guidelines.

It is very difficult to predict the chances of revival now. He needs periodic neurological assessment. Most often they may develop further complications like aspiration pneumonitis, chest infection, hypotension (low BP), etc. It is of major concern now and needs to be handled carefull.

Some patients if the brain stem is intact and other areas are partially intact, they remain in persistent vegetative state for log time. Gradually, he may show some improvement with supportive treatment. But, it cannot be predicted at this stage. You need to have lot of patience.

I suggest weaning him from ventilator and to go ahead with tracheostomy. Continue nursing care and physiotherapy. Drugs which can make him alert can be tried like Citicoline, Cognistar, etc.

I hope, I have answered your query to your satisfaction. I am available to address any other concerns that you might have.

Regards