Two developments today, both the subject of much prayer. First, Walter had an angiogram (a test that uses a special dye and camera to take pictures of the blood flow in the blood vessels of, in this case, the brain). Dad explained to me that an angiogram can discern things like aneurysms, tumors or narrowing or blockage in blood vessels. Walter's angiogram showed no such thing! It was normal. All the doctors detected was high blood pressure.
Second, the doctors discovered that Walter's sodium level was low, so they've started to treat that. The nurses told Lyn and Pat today that they have seen this treatment work extremely well in reducing swelling. Let me know if you want an explanation of the chemistry behind it and I'll have Dad write a guest post. In any event, once the swelling is reduced sufficiently the doctors will then be able to get a better look at the source of the bleeding. It is possible that the bleeding resulted from a leak from a blood vessel caused by, or at least exacerbated by, high blood pressure. If that's the case, then the only thing to treat is the high blood pressure, although physical therapy will still be required. This may be getting a little ahead of ourselves, but the prognosis may be much better than feared. Not out of the woods, but grateful for answered prayer and good news!
Good to hear! The old Holiday Inn Valdosta clan is praying for Walter, Jessica, and their families. We love you!
ReplyDeleteFrom a neurologist standpoint, a hypertensive bleed has better outcomes than a hemorrhagic stroke (and sometimes aneursymal bleeds). With a hypertensive bleed the area that is damaged is usually the brain tissue SURROUNDING the bleed. Once the body resorbs it, the once-so-large area on the scan can turn slit-like. In a hemorrhagic stroke the area of defect is usually the tissue UNDER the bleed. Aneurysms can be clipped and coiled, but they have other problems associated with them including vasospams or rebleeds. Days 3-5 can be kinda rough after a bleed because of the swelling effect. Afterwards when the swelling subsides, so will some of his symptoms. Rebleeding with hypertensive strokes are more likely to happen during the hospitalization if the blood pressure is not controlled and as an outpatient if the diastolic blood pressure is elevated. The hyponatremia is most likely to cerebral salt wasting or SIADH. Make sure that they are looking at both possibilities. They are treated differently. I am glad that he was transferred--although it sounds like the trip caused a setback.
ReplyDeletePlease utilize me a resource if you are not clear on what is going on or if you have any neurologic questions. If I am not able to answer them, I am in good standings with our Stroke gurus and interventionalists here at Univ of Pittsburgh. My thoughts are with you all. suskivr@upmc.edu