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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What are the damages caused to the brain due to a massive stroke?

A close friend age 44 had a massive stroke, lots of blood and fluid pooled in and around the brain. Removed part of his skull to relieve pressure. He didn t take blood pressure meds for a year. He is still in a coma (2wks). Only induced for a week due to brain seizures. Now breathing on his own after 2 weeks on ventilator off and on. Temp and BP issues but pretty stable now. Eyes fixed and dilated still. Little bit of movement in his feet and legs. They say his brain is ok and won t know the extent of injury until he wakes up. What cld this time span be and what damage could this cause if prolonged in coma?
Mon, 15 Jul 2019
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Neurologist 's  Response
Hi,

They are likely keeping him in the induced coma which is why his pupils are fixed and dilated until the swelling of the brain is down back to a more normal level. Then, they will begin to bring him out of the state to start the assessment process of his brain (especially since apparently, they cannot really confirm significant or at least obvious damage at this time). Usually, it takes brain swelling of that severe nature several weeks to several months to fully resolve so that baseline function can be assessed. Damage from staying in the coma at this time is going to be none to minimal since this is a controlled situation.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Dariush Saghafi, Neurologist
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Neurologist Dr. Dariush Saghafi's  Response
Hi,

If the doctors are telling you that his brain function seems to be intact what they are really saying is that his brain reflexes and cranial nerve functions are normal in so far as they can be tested.

However, something like language and level of baseline consciousness cannot be assessed until he is brought out of the coma. This will be best done when his brain swelling is totally resolved. This can take several weeks to several months. Don't be too impatient since this situation is being controlled and monitored.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Dariush Saghafi, Neurologist
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