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My grandmother recently hit her head off a cement veranda.

She was admitted to a...
My grandmother recently hit her head off a cement veranda. She was admitted to a hospital, during which they never checked for concussions or trauma of any sort. They stitched her up and sent her home. A day later she started having seizures and they brought her in for surgery and found out that she had been bleeding. They went in and stopped the bleeding. The following day she began having seizures again. They took her and places her in a coma. We were informed her brain was swelling. They have places her in medication to attempt to reduce the swelling for one day, and have already suggested without coming up with a diagnosis as to whether there may be more damage obtain else where on her intial injury that we should take her off life support. I know we need a second opinion.
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Answered in 1 hour by:
2/16/2018
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,265
Experience: American Board Certified Neurologist, Internal Medicine
Verified

Hi, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns related to your grandmother.

I am sorry to hear about your grandmother’s health as you have described above. As a Neurologist I frequently diagnose & treat this type of health situation and I can certainly help you in this regard.

It is unfortunate to hear they had missed the possibility of bleeding when she was taken to the hospital initially. In elderly individuals even minor head injuries can induce bleeding so there should be very high degree of suspicion for bleeding and she should have been evaluated for head injuries including brain scan etc during her initial visit itself - and this meticulous and methodical approach would have helped in detecting serious head injury such as this sooner and would have helped preventing complications, including also preventing the possibility of occurrence of seizures etc

I see she is now under medically induced coma.

This, as you may already know is done to give rest to the brain and also help with reducing the brain swelling faster, and this will promote the brain healing faster too.

In addition to the medical coma I hope she has also been receiving anti-swelling medications such as a course of steroid (such as Solumedrol IV Infusion) and Mannitol IV Infusion etc which can also help in reducing the brain swelling faster. Artificial ventilation with rapid breathing rate is another method that is used to reduce brain swelling.

And since she has had bleeding it is very important to see she does not receive any bleeder medications such as aspirin, blood thinners, heparin, clopidogrel etc.

And as far as your concerns related to removing her off of her life support – I really don’t think it can be done in such a hasty manner.

There are several issues to be considered before taking off the life support of an individual - for example the following various factors need to be considered before making a decision to take one off the life support;

A) For how long she is in coma like this?

B) What happens when they try to taper off the barbiturate that is used to induce coma with regard to the following parameters or findings;

1) How much recovery is there in her case?

2) How much alert she becomes?

3) How much deficits she is having as she comes out of the coma?

4) Can she breathe on her own?

5) Can she recognize you guys?

6) Is she aware of the self, and her surroundings?

7) Does she have control of her bladder and bowels?

8) Does she have ability to swallow?

9) Can she speak?

10) Is her memory overall good?

11) What does her repeat brain scan show? Has the bleeding stopped, has the swelling improved?

12) If she has had an EEG (study of the brain waves) done – does it show good healthy wave forms?

13) What is her neurological examination showing - especially is she having good brain stem functions? etc

As you see there are varieties of factors that need to be taken in to consideration before one can make a decision on taking a patient off of the life support, or not.

Her hospital doctors need to evaluate her current status in a meticulous and methodical manner as discussed above and after this only they can make a decision to whether to take her off of her life support or not.

Before they make any attempt to take her off her life support please try to bring forward the various points mentioned above with them and only after you guys receive a convincing answer to the various questions and concerns raised above then only you guys to make a final decision on whether to continue with aggressive therapeutic interventions for some more time, or whether to let them take her off from her life support.

Wishing your grandmother a quick & complete recovery!

Wishing you all - the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further. Please do not forget to take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. Rating me now does not close your question and if you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services!

Best Regards!

Dr Subbanna MD

Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 6,265
Experience: American Board Certified Neurologist, Internal Medicine
Verified
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