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What causes unconsciousness despite discontinuing sedatives after surgeries for brain hemorrhage?

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Posted on Sat, 5 Dec 2015
Question: my father undergone 2 brain surgeries on monday morning for brain hemorrage. After taking out the sedatives still he is not concious after 36 hr. Post surgery CT scan showed no new bleeding today they performed MRI which showes some spots in critical functional area. He has reflexive movement in feet fingers yesterday and today hand also vibrations in eyes. Please suggeat what can be done in this situation.
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Answered by Dr. Erion Spaho (46 minutes later)
Brief Answer:
More information about MRI and hemorrhage location needed.

Detailed Answer:
Hello and thanks for using HCM.

I have read your query and understand your concerns.

Spots on critical areas found on brain MRI, could be ischemic strokes that may be caused by embolism or cerebral vasospasms.

First, I need to ask you some questions about the nature and localization of the hemorrhage that was treated surgically.

Also I need to examine the MRI report, if you will upload it.

After this additional information, we can have a better understanding of your father's actual condition and expectations.

Awaiting for more information.....
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Erion Spaho (2 hours later)
I don't have MRI report with me. The surgery performed on left side it was intracerebral hemorrhage.
doctor
Answered by Dr. Erion Spaho (12 hours later)
Brief Answer:
Intensive therapy should be continued.

Detailed Answer:
Welcome back.

In this case then, probably lesions are located at brainstem ( this is one of the most critical areas ), and probably are ischemic due to previous compression by hemorrhage mass effect and surrounding edema.

Since there are movements, it is a good thing.

However it will take time for permanent damages to be evident, so, in this moment we can't be sure about the degree of the damage and the recovery degree.

In this situation intensive therapy to maintain normal oxygen levels, control of blood pressure, preventing infections and treatment of brain swelling should be continued.

Hope I helped you.

Wishing a good recovery to your father.

Greetings.
Above answer was peer-reviewed by : Dr. Yogesh D
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Follow up: Dr. Erion Spaho (37 hours later)
Thanks for the insight....actually they are taking out the ventilator and only giving the oxygen....so that they can check the response.... Movements r very insignificant according to drs here....they are saying even if he is OK without ventilator they r not sure if he can b open eyes or talk or when....pls suggest
doctor
Answered by Dr. Erion Spaho (5 hours later)
Brief Answer:
Follow up.

Detailed Answer:
Welcome back.

It is too early to be sure about progression, however, being independent from artificial respiration is a considerable step towards improvement.

Again, it is very important for me to have more information about MRI findings.

Best regards.
Above answer was peer-reviewed by : Dr. Raju A.T
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4329 Questions

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What causes unconsciousness despite discontinuing sedatives after surgeries for brain hemorrhage?

Brief Answer: More information about MRI and hemorrhage location needed. Detailed Answer: Hello and thanks for using HCM. I have read your query and understand your concerns. Spots on critical areas found on brain MRI, could be ischemic strokes that may be caused by embolism or cerebral vasospasms. First, I need to ask you some questions about the nature and localization of the hemorrhage that was treated surgically. Also I need to examine the MRI report, if you will upload it. After this additional information, we can have a better understanding of your father's actual condition and expectations. Awaiting for more information.....