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Dr. Andrew Rynne

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What Is The Prognosis After A Brain Stem Hemorrhage Stroke?

My uncle had a brain stem hemorrhage stroke last thursday. He has since achieved stabilised breathing but still has a small percentage of ventilation support, his kidneys and bowels are functioning but he hasn t woken up. He appears to move randomly and also flickers his eyes now and then when spoken to. He is said to have had intrapontine bleeding. He was on sedation from last thursday until monday. What are his chances of waking up?
Mon, 5 Feb 2024
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Internal Medicine Specialist 's  Response
Hi,

An intra-pontine bleed generally carries a poor prognosis and the prognosis can vary depending on the level of consciousness at presentation, size of bleed, location of bleed within the pons, and extension of bleed into the nearby structures. Usually, an intra-pontine bleed may lead to a condition called "Locked-in-syndrome" where patient's mind is said to be locked within his body, that is, he cannot move his body(except for vertical eye movements) but he can hear and understand what is happening around him.
If he is moving randomly, it could be an incomplete locked in syndrome
where some of the motor activities are preserved.
Physiotherapy has been found to be helpful in some cases for improvement of muscle power. For further detailed assessment of his chances of waking up and further prognosis, please provide the CT scan reports. You may also consult his neurologist who can clinically assess him as well and give you an expert opinion in this case.

Take care. Hope I have answered your question. Please let me know if I can assist you further.

Regards,
Dr Devi Venugopal Rita, Internal medicine specialist
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What Is The Prognosis After A Brain Stem Hemorrhage Stroke?

Hi, An intra-pontine bleed generally carries a poor prognosis and the prognosis can vary depending on the level of consciousness at presentation, size of bleed, location of bleed within the pons, and extension of bleed into the nearby structures. Usually, an intra-pontine bleed may lead to a condition called Locked-in-syndrome where patient s mind is said to be locked within his body, that is, he cannot move his body(except for vertical eye movements) but he can hear and understand what is happening around him. If he is moving randomly, it could be an incomplete locked in syndrome where some of the motor activities are preserved. Physiotherapy has been found to be helpful in some cases for improvement of muscle power. For further detailed assessment of his chances of waking up and further prognosis, please provide the CT scan reports. You may also consult his neurologist who can clinically assess him as well and give you an expert opinion in this case. Take care. Hope I have answered your question. Please let me know if I can assist you further. Regards, Dr Devi Venugopal Rita, Internal medicine specialist