A similar thing happened to my mother in law a few years ago. She was in the ICU for three weeks and “awake and aware” didn’t come for quite a while. She moved from the ICU to a long term acute care hospital and was there for… some amount of time (a month, maybe?) before transferring to a nursing home and then, eventually, home.
She wound up with some right-sided weakness but with physical therapy was able to progress enough that she walks without any assistance at all. In her case, the damage caused fairly severe personality changes as well as some communication difficulties; sometimes she has trouble coming up with the right words (which, coupled with her new personality, causes anger outbursts during which she’ll repeat the same swear word, usually bullshit or goddamn it, a few times) and she sounds like a five year old.
She also can’t plan properly and has poor impulse control so, while she has no problems with toileting and maintaining her own hygiene and can even cook some things, I’m not sure she’d have been able to go home if her husband hadn’t been around to supervise her.
In an effort to keep her out of state family in the loop, I blogged her experience. I could share a link to that if you’d like.
My sympathies to you. I remember well the uncertainty, fear, conflicting information, etc. It’s enough to drive you crazy. My best wishes for a positive outcome.
An aneurysm is just an area of a blood vessel that is weakened for whatever reason (could be congenital but certainly there are controllable risk factors). Aneurysms are not necessarily a problem and are not necessarily treated and are often asymptomatic. Problems don’t happen until an aneurysm ruptures and blood gets where it’s not supposed to be. If that occurs in the brain it causes a hemorrhagic stroke which is different from an ischemic stroke which is caused by restricted blood flow.
I’m in California and he’s in Ohio, so I’m going to be relating things I’m getting from others in my family.
The word is that he is awake and talking, and that he does not seem to be showing any motor problems. I don’t know if that should be “yet” or if the danger of something like that has already passed.
So he has a lot of blood on his brain. They did an MRI and could not find the site of the aneurysm. They said it’s possible the aneurysm clotted? Something like that. But I’m not sure what that means going forward.
They said they will be keeping him in the hospital for a minimum of 3 weeks. I don’t know if that’s necessarily in the ICU. NO matter what, they want him out of work for at least 3 months.
From my mom: “They have not found the rupture area yet. But the doctors, etc. are checking him for stroke signs every hour and his blood pressure every two hours.
He is also required to walk–don’t know how often.
There will be a repeat of the tests on Thursday: angio-gram, CAT scan, MRI, etc. whatever they think might help pinpoint the aneurysm area.”
He had a bad night, apparently, with a rise in his blood pressure and a worsening of his headache.
I don’t know anything about brain aneurysms, so is a rise in blood pressure dangerous for the aneurysm (especially since they haven’t found it), or is it more of a risk in general for Unspecified Bad Things?
It’s increasing the risk that the aneurysm might stretch too far and break. A break can be a a big tear and bleed very quickly, or it can be a tiny break with just a trickle of blood getting through before the body makes a clot there. The headache has them concerned because it can be a sign of pressure building in his head, which might happen if he was bleeding somewhere and the blood had no where to go, increasing the pressure inside the bones of his head. Or it could just mean he’s been forced to lay in an uncomfortable hospital bed and his neck is cricked funny. So both of those are on the “watch carefully and try to make it go away” list, but not the “emergency now!” list.
General question for anyone who knows: I know upthread SilverFire talks about hemorrhagic strokes as opposed to ischemic strokes. I was told my brother had had an aneurysm and a stroke. Is that likely to be that he had an aneurysm (the weak spot) and a bleed (the stroke), or am I supposed to understand it as a bleed plus the “regular” type of stroke?
I guess I’m confused about these terms. I didn’t know there were other types of stroke.
IANAD, but my understanding is that an aneurysm (weak spot in the wall of an artery) will burst, causing a hemorrhage, which than damages the surrounding tissue, causing the stroke.
There are two main kinds of stroke: hemorrhagic stroke and ischemic stroke.
Hemorrhagic Stroke: If an aneurysm ruptures, it will cause a bleeding. Downstream of the bleeding, there will be an area of the brain which is cut off from blood and doesn’t get the oxygen it needs. This will damage that area, either a little or a lot.
Ischemic stroke: Rather than a bleeding blood vessel, you get a blood vessel blocked by a clot. The clot can form right there in the spot it blocks, or it can come from somewhere else in the body and get stuck in the spot it blocks. The area downstream of this blockage is cut off from blood, and doesn’t get the oxygen it needs. Just like a stroke from a ruptured aneurysm, this will damage that area, either a little of a lot.
So you can see why they’re similar in their effects, although they’re “opposite” processes. The end result of both is that part of the brain is cut off from blood and starved of oxygen. It’s difficult for me to interpret what your brother’s situation is from those words.
(For the sake of completeness, but not really relevant to your brother’s situation: there are two other kinds of stroke, a hemorrhagic stroke from a malformation in the artery and vein in the brain, and a TIA, which is also called “mini strokes”, which are like ischemic strokes but then the clot moves and the blood flow is restored without the doctors doing anything to it.)
Be careful with vital signs. I know you’re not there and are possibly getting this information second and third hand but, in many cases, stroke patients will have wonky vital signs on purpose. And of course they sound bad because we know what “normal” should be. Unfortunately, there are lots of medical staff who, for whatever reason, don’t take the time to explain things so they say that his blood pressure was XXX/YY without any commentary and you think “crap, that’s really high” when, in some cases, they do things like keep BP really high on purpose, or other treatments they use will make hemoglobin plummet (at which point they should say “but that’s totally expected, so we’re not going to freak out…” but they don’t always remember that we don’t necessarily know what they know) or whatever.
Just be aware of that. Abnormal vital signs may be fine right now. The only way you can know if something is really bad, merely an anticipated consequence of treatment, or even an optimal value is to ask.
And. . . one other thing to consider. . . It sounds as though none of your information is coming from the doctor(s). You have to allow for some mistranslations/miscommunication from someone relaying what (they thought) the doctor told them.
My mother in law had a serious aneurysm when my husband was in high school. 15 years later she’s still kicking around, living it up retired in a small town in Mexico. She has some trouble in speech, long pauses, lost train of thought, but I don’t know if she had that before the aneurysm or not. None of that negatively effects her life.