Hello. Thanks for asking from HCM. I can understand your concern. I am sorry to hear about your mother s condition.The decompressive surgery, to stop brain bleeding and relieve pressure effect on brain, outcomes are not very good because patients are mostly in very bad condition. Most patients require prolonged ventilatory support in ICU (intensive care unit). Thats why tracheostomy is done frequently in such patients The low blood pressure could be due to shock (neurogenic or hypovolumic or septic). It can only be confirmed by blood culture, cardiac status, checking brain reflexes and response, measuring blood volume. It requires expertise and investigations. You can confirm it with her treating doctor or you can provide all these details by asking another question, only then we can reach upto some conclusion. Low blood pressure in a brain damage patient is a bad sign. It means blood supply to brain has decreased. It will further damage and stop the healing process. Tracheostomy will be delayed as sometimes it can cause damage to major blood vessels. This damage can further lower the BP and thus can lead to grave consequences. Ask doctor what medication and fluid is going on? For low BP, she can be given : Intravenous fluids like normal saline after prescription : Intravenous ionotropes like Dopamine/Adrenaline after proper prescription ; Intravenous antibiotics like Penicllins, Amikacin etc. to treat infection. ; Keep her head at lower level than chest ; Rule out deep venous thrombosis by doing D-Dimer assay and USG (ultrasound doppler) along with above causes. Hope it will help you. Thanks. Take care.