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Forum Name: Neurology Topics

Question: What is prognosis for comatose stroke victim?


 jdohe - Fri May 29, 2009 1:21 am

My 65 year old step-mother had a stroke 50 hours ago. She is 5'6 and about 200 pounds. The description I was told is that she was found flopping around on the floor and her body was cold. She is in the hospital and has been in a coma since being found on the floor.
I know that it is important with heart attacks and strokes to get medical attention as soon as possible to greatly improve the chances of recovery. In this case, it could have been hours that she was on the floor before being found.
I have tried searching the internet for realistic expectations about her chances for recovery, but all of them are quite vague and only give general stroke recovery statistics without regard to the immediate aftermath of the stroke. For instance, a person obviously has a better chance of recovery if they never lose consciousness or if they are unconcious for only a short time. I know that sometimes coma's are induced to facilitate healing, but her coma is not induced.
Can someone give me some blunt, realistic outlook of her prospects? I've read that even if she recovered, she won't be able to drive or work anymore. Will she die? Might she be in a coma for years? Is brain surgery likely? I may have to move back home to take care of my father, so this information is important. Frankly, my assumption is that she will die within a week. My father is 75 and can't live by himself.
It is even more of a sad situation because her stroke occurred just 2 days after retiring from the school she worked in. She retired because her adopted daughter just graduated from the school, and this is the end of the school year.
Am I wrong in assuming that the stroke I have described is much more serious than the typical stroke?
 John Kenyon, CNA - Tue Jul 07, 2009 12:02 am

User avatar Hello --

This is a very difficult question you ask, which is why the things you've found on line about the subject are so deliberately vague. Statisitically the outlook is, of course, worsened, but statistics are very tricky, and a stroke in a seemingly innocent location can sometimes have a poor outcome while some of the more serious ones often resolve either with much work or sometimes spontaneously. The fact is with comatose patients things become really complex because coma is so poorly understood, even in the setting of severe head trauma. Some people wake up promptly and function well while others may linger for a long time, then the odds seem to split between very good outcomes and pretty poor ones. Unless the focus of the stroke is known and is recognized as a very bad area for one, then it becomes extremely difficult to predict anything with any accuracy. In these cases it is usually most wise to hope for the best and prepare for the worst, since there is so much about the injured brain that just doesn't follow any textbook, even though it should.

I wish I could give you a more concrete answer, but unless you have access to some information about the location and extent of the stroke it's pretty difficult to even hazard a guess. Meanwhile I will continue to hold good thoughts for your mother and hope for the best, since with these sorts of situations almost anything is possible. If you are able to learn more about the location of the stroke and any other information, and bring it back here, we may be able to give you a better idea of the likely outcome. Meanwhile, again, hope for the best but be prepared for anything.

I do hope this is helpful. Good luck to you and to your mother.
 jdohe - Wed Jan 13, 2010 11:58 am

She died a day after I posted that question over 6 months ago.

However, I am interested in hearing some opinions about something else related to her death. My dad's wife was 65 when she died. She and my father purchased a baby from Peru 19 years ago because they were considered to be unsuitable parents - partially due to age - to adopt a baby in the U.S. The baby girl (now 19 years old) and my dad's wife were inseperable. They went everywhere together, my dad's wife got a job volunteering at the girl's private school just to be near the girl, and they slept in the same bed until the girl was 15 years old and my dad forced them to stop (it didn't stop completely however).
First, the stroke occured one week after the girl graduated from that school, which essentially made it impossible for my dad's wife to be within a hundred yards of the girl 24/7. I think that may have triggered the stroke.
Second, as bizarre and unbelievable as this sounds, it is completely true. The stroke occurred on the 27th - she never regained conciousness - on the 29th the adopted girl went to a birthday party - on the night of the 30th they were told she only had hours left to live - she did die hours later - 2 hours after dying the adopted girl went to a graduation party! Is that not the most cold-blooded thing you have ever heard? I don't think any normal person would be physically capable of going to a party under those circumstances.
 Alicia Arden - Sun Feb 28, 2010 1:26 am

Dear sir,
My father is Hypertensive, non-diabetic and was a chain smoker. He had strokes in may 2007,march 2009 and august 2009.In the last stroke he had a massive sub arachnoid hemorrhage and was unconscious for 5 days. Now his right side has upper motor type paralysis- he can't stand and his Rt. hand flexed at the elbow joint. After the stroke when he recovered he was able to recognise us, tell our names, and expresss his feelings sometimes. Then due to catheterization for 5 monthes he developed UTI by Pseudomonas. He was treated with I/V Gentamycin 80mg thrice daily 7 days and Tab.Oflaxacin 200mg for 14days acc. to c/s report.
Now he can't speak (not even our names), can't recognise us, always screaming, always very angry, doesnot sleep at night, doesnot co-operate when we give him food or medicine.

Now my father is taking the following medicines:

Morning:
1. Indapamide+Perindopril combination

Night:
Propranolol 50mg
flunazepam 30mg
Quitipine 100
Perkinil (Procyclidin) 5mg
Atovastatin 10mg
Phenobarbital 60mg
Multivitamin.

My question is: is my father's condition deteriorating or is it a result of drugs side effects? My father hardly speaks now-is his Broca's motor speech area affected now?

Please advice me on what to do.

Thanks.

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