Stroke - widespread haematoma

[newdoll]

My dad was on warforin for deep vein thrombosis for the past 5 yrs. May 30, 2006 he had a stroke around noon followed by haemorrhage, bleeding stopped at night around 8PM. He has no history of hypertension, age 61yrs. MRI done on June 10 impression- "Parenchymal haematoma involving right thalamus, lentiform nucleus, posterior limb of right internal capsule, adjacent portion of right temporal lobe and upper midbrain, causing mass effect. Mild focal midline shift with evidence of obstructive ventricular dilatation, ventricular extension of haemorrhage observed. Minimal subarachnoid haemorrhage, cerebellar atrophy changes." No significant change in size of haematoma or ventricles from the last CT scan done on June 2nd.
He is doing well with his vital organs, breathing on his own. In consious state but not talking, neither can he feel our presence. Reflex movements in limbs and eyes. Need an opinion as to go in for surgery to clear certain haematoma region leaving the risky part or to wait and watch. If surgery done, how much will be the improvement.

Bindi

[caregiver222]

Well, you listened to the doctors and the warfarin is probably the direct cause of the stroke. Keeping somone on warfarin for five years because they at one time experienced a deep vein thrombosis is a questionable protocol. At this point you have a very complex situation, and there is no correct answer. Every direction involves risks and benefits. You need to search the net and come up to speed on the options so you can discuss them intelligently.

[star queen]

Hematoma is blood in the brain caused by leakage in a vessel.  The danger of hematoma in the brain is that it will take up space in the skull causing pressure on the brain tissue.  This pressure can call brain cell death and permanent damage to the brain.  If the blood continues to accumulate in the head, the cranial pressure will rise and can also cause brain cell death.  The extent of damage depends on where the cell death occurs on the brain and how much pressure was present to cause the cell death as well as how much tissue died.  The question of surgery is a difficult one.  If you do nothing, he may suffer brain cell death that may leave him (worse case) a vegetable. Surgery carries the same dangers, so what to do?  My suggestion is to listen to the doctors, and consider what your father would want for himself.  Which would he chose if he could chose?  It's a no-win situation where your father is certain to suffer some damage either way. If you do nothing, the hematoma certainly will cause damage.  Will surgery lessen the damage, or stop the damage from the hematoma?  A tough choice under the best circumstances. God Bless