Conjestive Heart Failure Brain damage has ocurred

[island]

My father who is 70 years old had conjestive heart failure and went into cardiac arrest after 48 hours he was not responding as should be all vital signs looked good but he went approx 2 minutes without oxygen to the brain so they say as a result the Dr. has told me my father's body has survived but his brain has not he was taken off the ventilator and is now breathing on his own but their has been little response from the brain eg. not speaking seems to be at some type of coma state although he responds to our voices with his eyes have been able to get a little squeeze from his hand we know he is their this is day 11 we were told severe brain damage but the cat scan came back normal we are wanting him to see a neurologist or visa versa are we going down a dead end what hope is their of recovery and to what extent of recovery we need some direction I am also worried about pneamonia setting in as soon as the ventilator was taken out he was taken out of ICU 24 hrs later we are trying to bring him out of this what direction should we be going with all this should we have an MRI done will this give us some clues when the cat scan came back clean he must be transported to get the MRI done is their a risk of making him travel re. ambulance.  Frustrated and need more direction will reabilatation help etc. He has moved his head very slightly he will stick out his toungue when we ask him he will shut his eyes tight if we ask him if he knows we are their CAN THE BRAIN LEARN AGAIN.

[Kevin Pho, MD]

The neurology referral would be the most reasonable option.  There are several tests to test to extent of brain damage.  This would include CT/MRI, EEG, somatosensory evoked potentials, and serum ammonia level (extremely high levels suggest a poor outcome).  

Here is a study that looked a prognosis of people in comas.  There are 5 categories:
1) Death or persistent coma
2) Persistent vegetative state, in which patients are conscious but are not aware of their surroundings
3) Severe disability, in which patients are conscious but disabled and are dependent upon others for activities of daily living (ADL)
4) Moderate disability, in which patients are disabled but able to perform ADL without assistance
5) Good recovery, in which patients are able to resume normal life, possibly with minor neurological or psychological deficits

Many authors define a good clinical outcome as moderate disability or good recovery, grouping severe disability, persistent vegetative state, and death as poor clinical outcomes. In one review of 500 patients who suffered nontraumatic, anoxic brain injury (excluding drug-induced coma), 16 percent of patients had a good recovery or were left with a moderate disability, 11 percent of patients were left with severe disability, and the remaining 73 percent never improved beyond a vegetative state. Of the patients who remained in a coma at 1 week, 7 percent improved to a good recovery or moderate disability. None of the patients who were in a coma at 2 weeks improved beyond severe disability.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[GRIMPER]

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[mandy092570]

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