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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What is the next treatment for the patient in coma?

hi i am looking for a answer about one patient who has history of mitral valve stenosis and repaired with prosthetic,h/o lacunar stroke,recently became unconscious and taken to the hospital where she is in coma GCS E2V2M2, developed subdural and subarachnoid hematoma with hydrocephalus ....mri is done but they can not do angiography due to her prosthetic valve,she is in mechanical ventilation.what is her next treatment line would be and what her chance to survive or recover
Thu, 14 Aug 2014
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Thanks for asking the question.
I am Dr Adil.

After going through the details of your question, i noticed that your patient has many problems, she has mitral valve stenosis, prosthetic valve, i presume that mitral valve stenosis may also caused her atrial dilatation and atrial fibrillation that had lead to the embolic stroke.

Now she also has sub-dural and sub arachanoid hematoma.
So these are so many problems, one correct one problem at a time, and all these problems require surgery and for surgeries and anesthesia one needs a good and sound heart and she is also on mechanical ventilation, and long term mechanical ventilation also compromise the function of lungs.

I am not seeing a good chance of her recovery.
But in medical sciences, miracle do happens.
I wish her well and hope, may she wake up soon.
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