Standard Treatment for Acute Hemorrhagic Stroke

[redbird81]

I was curious if the standard, acute treatment for a hemorrhagic stroke included an emergency vent shunt.

My sixty one year old father suffered a severe hemorrhagic stroke 10 months ago. He received a CT scan upon arrival at the emergency room where they determined he had a hemorrhagic stroke. At that point he was considered a 3 on the Glasgow coma scale. He was pretty much left alone after that and it wasn't until 16 hours later that they finally put an emergency shunt in his head and this was only after intense, urgent pleading on our part, convincing the internist he WAS showing signs of life by sticking out two fingers for us.

Could you please tell me reasons for NOT administering a shunt in this type of situation. I was under the impression that time is always critical in the case of a stroke.

Thanks so much!

[Abhijeet Ghosh]

Dear Friend,
We really can't comment as why the treating doctor didn't went for a shunting operation as it can be left to his discretion and analyzing the present condition of the patient.
A Coma scale of 3 might had made him cautious in his approach.
Also considering the fact that the Glasgow coma scale must had improved as you have clearly mentioned that your dad was able to do a bit of finger movements (at a score of 3, there is no movement possible).
Hence please don't think that the doctor was not doing his part correctly, it was just the fact that he was buying out time, for a bit improvement in the coma scale.
How is your father doing now?
Regards

[Hope4Linda]

My mother also suffered a hememorrhagic stroke last year.  It was a very big bleed. She was in a coma for 3 weeks.  The doctors did not recommend a shent.  A few surgeons did want to do surgery, but we did not let them, as it would cause more damage.  She is recovering, slowly, baby steps. My thoughts and prayers go out to you and your family. It is a daily struggle!

[redbird81]

Hope4Linda, thank you for your kind words. I hope your mother is starting to make great strides in her progress and I pray that you are finding peace in the midst of the struggles.

Abhijeet V, thank you for your response. Hindsight is 20/20. I do feel for everyone in a situation like this. It's so easy to look back and wonder why more intense measures were not taken. I am eternally grateful for all of my father's doctors and what they did for him. Stroke recovery is a slow process, not only for the stroke victim, but for the family as well. It takes a while to process the event and all of the pain.

Dad was making a miraculous recovery considering the extent of his brain injury. He regained great movement on his left, affected side and was walking with the use of a walker. Mentally he is still himself, with a few more hiccups. Words don't come to him as easy. I would say it took a good 4-6 months to get to that point. At this point he had no aphasia and we were thinking there was a good chance he would be able to work again.

Unfortunately he was in a car accident (he was not driving) and was once again in the ICU on a vent in a medically induced coma. He had severe injuries, two collapsed lungs, 8 broken ribs, broken scapula and pelvis...slight head injuries, but has once again survived. I call him the invincible ironman, ha! All of his stroke injuries are now exacerbated and unfortunately he now has moderate aphasia. He's still able to get around with a walker and mentally is still himself...just on a much more slower scale.

We all are having to "regrieve" the stroke as well as the car accident now. It's tough, but he continues to improve. It's just an extremely slow process. I'm just so grateful he's still with us and we cherish every day he's here.

Thanks again for the responses! God bless.