Suggest treatment for seizures after a small stroke

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Posted on Sat, 6 Jun 2015 in General Health
Question: My husband has a small stroke on Tuesday followed by a brain bleed as a complication of the medicine given to help the original stroke. He was flown to a neurological ICU and has not awaken. He is on a feeding tube and today had a seizure. Is there any chance he will recover. I need am honest answer.
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doctor
Answered by Dr. Olsi Taka 38 minutes later
Brief Answer:
Can you provide CT/MRI report?

Detailed Answer:
I read your question carefully and I am sorry about what has happened to your husband.

Stroke can have several grades of severity, according to the size of the infarcted area or the volume of the hemorrhage. For that reason to make an approximate prediction it would be very useful if you could provide the CT or MRI report. Also if that is not possible you could give some more info on his condition, is he intubated, does he open his eyes, understand simple orders, emit any sounds, does he has movements on one side or none at all.
If you could provide some info on the above as well as other previous conditions which might influence recovery (for example diabetes is a bad predictor) I might be more helpful.

I will be at your disposal for a more decisive answer as soon as you provide some of the above mentined info.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka 16 minutes later
He is intubated and has not opened his eyes. There is less limb movement today, but there has been movement. He had a seizure this morning. The brain bleed is not enlarging (which seems to be the only good news), but has also not gotten smaller. He has been sedated because of the seizure and BP issues so some tests remain to be done when he stabilizes. He has diabetes.
doctor
Answered by Dr. Olsi Taka 59 minutes later
Brief Answer:
Read below.

Detailed Answer:
Thank you for bringing some more info. I am assuming that you don't have the CT or MRI report at your disposal since you don't mention it. If you can have it later I'll be glad to look at it.

By your description it seems that the hemorrhage is severe, since he is in a coma and needed to be intubated to maintain airways. The prognosis is generally not good. Around 58% of stroke patients who need to be intubated do not survive the first month. Of the remaining who do, about two thirds remain with various degrees of disability, so the chances of full recovery unfortunately are low. The seizures and diabetes are not a good prognostic factor either.
Regarding the brain bleed getting smaller, even if things go relatively well, it will be a very slow process, that brain bleed won't get smaller in a few days or a week, it will be a slow blood degradation and absorption process, often complicated by swelling of the surrounding tissue. So if it's stable and there's not much swelling is not necessarily bad news, you have to be patient.

Hopefully things will work out for the best.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 24 hours later
There is less movement today and he is still asleep. Is there any hope at this point?
doctor
Answered by Dr. Olsi Taka 23 minutes later
Brief Answer:
Read below.

Detailed Answer:
I am sorry about the anguish you seem to be in.

I am afraid I can not give you a different answer from yesterday though. As I told you even in the best case scenario, improvement wouldn't happen in a day or two, but would be a long long process.
As for worsening it is hard to assess, since if he has been sedated he may be in a pharmacological coma induced by doctors in order to stop seizures and protect his brain. So if still sedated the lack of movement might not mean much. Since there is some movement (judging by the word yes), that means he is not in the deepest scale of coma, so some hope is left.

Feel free to ask further questions, but since you still do not provide CT images or report, I wish you could discuss these issues with his doctors as well and try to refer me their findings and opinion. I am more than willing to help, but without imaging and no possibility of examining your husband, it's tough to give a responsible answer, more info is needed.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

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Practicing since :2004

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