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Sustained brain swelling following stroke
aprilofvt posted:
Hello. Thank you for reading. This is long--I just wanted to be thorough

My stepfather, 47 years old with a history of heart disease that was recently deamed under control, had a massive ischemic stroke in the middle of his right cortex on December 23rd. MRI showed damage to about 1/3 of the cortex in this hemisphere They do not believe there was a heart attack involved. My mom found him on the floor of their home when she returned from work; he may have just had it or may have been there for up to 5 hours--based on his last telephone contact. Blood busting meds weren't given due to the unknown amount of time since the stroke. He began vomiting as she went to assist him and called 9-1-1. I met them at the hospital.

The stroke resulted in complete paralysis of his left side, serious head pain, disorientation and an oddness of how he used his eyes. His speech was quiet and mumbly but he could respond and seemed to comprehend much of what was said. He was only on oxyen for a short time and he was able to breathe. He was given a feeding tube after some time.

His swelling was significant--he was monitored hourly in ICU and surgery to open the skull was brought up many times but never done. Drs were cautious as he was on high levels of blood thinners prior to the stroke. A medication (Manatol?) to reduce swelling was tried, however the swelling continued. As soon as his scans seemed to show a slow/stop in the advancement of swelling, his condition would regress and a new scan would show more swelling. Although drs said that the swelling usually peaks around 3 daysm it went well beyond that. They began giving him high doses of sodium to reduce swelling and intentionally increased his blood pressure.

We began to see an improvement in his alertness and on Jan 3rd, 11 days post stroke, his catscan showed a slowing in the swelling. They began to talk about getting him out of ICU--that they would wean him from his meds for the swelling as not to cause more problems, and then move him to the neurology floor. After the 3rd, he was moved to neuorlogy and was again moved to a rehab center by the morning of the 6th even though he had spent the last day vomiting. It all seemed so fast!! (Which I didn't understand because they were going to wean him?)

He continued to vomit, the headpain worsened, he had to cover his face to block the light and couldn't eat. The began therapy and he tried to participate but still couldn't eat. He continued to vomit day after day, his bowel became impacted and his blood pressure wouldn't come down.

This morning, January 11th, the did another scan and it showed that his swelling has not gotten worse, however it hasn't come down either. They are now putting him on steroids.

Is this usual for brain swelling to continue to be so problematic 20 days post stroke? What other therapies may they be overlooking? I have asked my mom to look into having them augment his oxygen since I have read that that can reduce the swelling and improve the oxygen levels to the brain. I feel so bad for him. He is so young and in such agony. I worry that the longer this swelling causes problems, the more difficult his recovery?

Are there any resources you would suggest I look into?

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