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Post Stroke Behavior
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Post Stroke Behavior

My 76 grandmother just had a brain anuerysm surgically clipped.  Before the surgery she was a normal functioning female.  It has been 2 weeks and she is now in rehabilitiation.  Her behavior is bizzarre.  Her short term memory is basically gone.  She remembers things long term as if she was still in that period of time,  We noticed that depending on which family member is there her behavior is different.  For example when I am there she is calm, when my aunt is there she is hostile and non compliant.  When her husband is there she acts incompitant.  There are times of clarity and other times when she is completely in her own world talking about things that make no sense.  The neurosergion mentioned that during the operation she had 2 mini strokes.  Is this common post stroke?  Is this something that gets better with time?  
Tags: Stroke
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Surgery is risky.  Assuming that she had a life threatening aneurysm, it was a necessary surgery.  Anesthesia, the trauma of the surgeons moving around in there, and the loss of blood supply necessary with the aneurysm work itself all cause brain trauma.  

I do not know what your surgeon means by "mini- stroke"  but it implies that there was a loss of circulation to the brain in a few places.  A stroke is caused by something that blocks a vessel.  Ischemia is  blockage that is transient.  The procedure may have released matter into circulation that got stuck.

It is an adverse surgical outcome and you will need to discuss this with the hospital's review board if you are concerned if it was an expected or unexpected adverse outcome.

A right side effected stroke can cause communication problems and is considered worse by patients due to the frustration of losing movement and communication.  A left side effected stroke can cause severe mobility problems but most of the communication center can survive.

Different behaviors can be mirroring of what the people are presenting to the patient or can merely represent a different time of day, nutrition or hydration.

I would guess that you are a calm, cheerful person in her presence.  Her sister is probably frustrated at her sister's condition and coming across as being upset so the patient is assuming the harshness is directed at her.  Her husband is a male and she may be reverting to a childlike relationship she had her father or she just wants him to make everything all better.  It is possible that he is perfectionistic and she is afraid she will do something wrong, so she does nothing.

The rambling is when the nerve cells can't find the pathway.  She could be recapping or reponding to television, nursing staff, memories - much like being in a dream.  It could be a form of coma.  Alternatively, this is the damaged communication center of the brain and she is using wrong words instead of right words.

You are very observant and your observations may be useful to a person who is trying to diagnose the problem and to create therapies.  You may want to bring in a stroke expert at this point because immediate therapy and treatment is better than waiting.  There may also be bleeding in the brain post op or other problems that a consult may reveal and the surgeon can act upon before discharge to a rehab facility.

This has begun to go beyond the world of the surgical neurologist (except for post op problems) and more into trauma and stroke therapeutic treatment.  Start working with the hospital staff to locate a good stroke rehab facility if her general health is ok.
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