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View Full Version : advice needed cousin has had bleed on brain.


pamuk
10-06-2006, 04:47 PM
As many of you know I have been a member of this forum for a couple of years following the discovery of my five unruptured annies and the subsequent coiling of three of them. I thought my annie journey had actually taught me a lot about the brain but I now know I actually know very little! and I am now needing advice since my cousin has had what has been described as a bleed on the brain. My cousin is single, no kids her parents are not alive so her cousins are her nearest relatives, I am the closest to her locally - a lot of my family live overseas, so I am listed as the hospital contact for the family.
Can anyone tell me the difference between a stroke and a brain haemorrage,
I thought I knew the differences but apparently I dont

I got a call just over two weeks ago to say my cousin had been admitted to her local hosp (about 6 hour round trip from where I live) with a stroke. My understanding of a stroke then was a stroke is caused through oxygen reduction to the brain from a blood clot.

The next day the hospital told me that she was in a bad way was paralised down her left side and could not even swallow.They had done a CT scan which suggested a stroke. They also mentioned she had fallen out of the hospital bed bed twice though the night!!!. and sustained some bruising.Friends that had visited her that day said she was in a bad way. shouting screaming in pain and the hospital were trying to get her pain meds established. I asked the hosp on the phone if she had had a SAH (and explained annies were in the family etc) and they said well she has had a stroke and so bleeding will be involved. I didnt understand that statement I didnt think that bleeding was automatically involved with a stroke. The next day I saw her and she had got some swallowing ability back and her speech although a little slurred was ok, her memory was fine and she could hold a normal conversation, but she had no feeling down her left side and was still complaining about the pain in her neck and head. I had another word with the staff about the bleeding and they said they were going to do another brain scan. The next day I got a phone call to say they were transferring her to the Regional Neuroscience Centre, surgical ward an hour away, this is the centre where I had all my annies coiled. she was being transferred to the same ward I was on last year.. I asked why she was being transferred to a surgical ward and they said the second brain scan had revealed a second bleed and they thought she may need surgery.

I went the next day to the Neuro Centre and it was strange going there as a relative as the last time I was on the ward I was the patient. She was much better, able to swallow almost normally with much improved speech and her memory was fine, cognitively fine, but still parilysed completely down the left side. I was amazed at how well she was considering the fact she had had a second bleed. I spoke with the staff who said she was there for observation only. I asked why she was on this surgical ward and they said that she was there in case she needed urgent surgery and there was a high risk of that, but she was just being observed for the time being. She has since been seen my neurosurgeons, neurologists etc and there has been some slight improvement. The neurosurgeons confirm she has had two bleeds but say that surgery is not necessary? Today I got a phone call to say that she was being transferred back to the local hospital she came from as she no longer needs to be on a surgical ward (she was on it about ten days) as the threat of the need for imminent surgery no longer exists!. They say that surgery is unnecessary (I dont understand this) and even if she had surgery it would not bring back the feeling to the paralised areas and trying to recover some feeling in those areas that is the most important thing now. The local hospital has confirmed all this and they say that physiotherapists will work with her and bring her to her maximum potential after which she will be discharged once care has been arranged, they say she may be able to have carers at home, but nursing home care may need to be arranged.

I still dont know what has caused this bleeding from a blood vessel as they put it, I thought that the only cause of bleeding from a blood vessel was an annie but they wont confirm she had an annie, does anyone know if a blood vessel can just bleed say through a tiny weakness that isnt an annie? or if a stroke can be something else rather than a blood clot as I thought it was - the hospital have never said she has had a blood clot, they have always maintained that she has had two bleeds from a blood vessell, and the way they say it makes it sound quite a frequent occurance but it isnt something I have heard of. Also I always thought surgery was automatic after these type of incidents, has anyone had this experience when surgery hasnt been performed?

The whole thing has been a bit traumatic for me, it is only a year since she was visiting me in the same ward she was on. When I looked at her I realised how lucky I had been to find out about my annies and get them treated, but I also felt anxious because I still have another two annies they are just monitoring and I thought well I could also be looking at my future.

Thanks for your help

pam

annie2105
10-06-2006, 05:29 PM
hmmm... I am not sure about the medical definition but I do know my doctor told me I have had a stroke due to the lack of blood to the artery when mine burst. Sorry i can't help more but blessings to you and your cousin!
Cheers...Lisa

Lyn
10-07-2006, 09:18 AM
Hi Pam

Guess it makes me ignorant but my knowledge of strokes seems pretty much the same as yours. So sorry to hear that this has happened to her, and I hope that things will improve.

Don't stop digging - it could be information that is useful to you or maybe other members of your family.

Thinking of you

Lyn

hattyuk
10-08-2006, 04:59 PM
Hi Pam,
sorry cant help you with any information, but I am praying for your cousin and you at this difficult time. I actually had no idea what an aneurysm was until well after my surgery and I looked it up on the internet and this site, it has been so helpful. My husband had a 4 hour round trip to see me when i was in hospital, it must be very difficult for you.
Take care hatty ***

dawnmn
10-08-2006, 05:20 PM
Pam,
Here is information concerning different strokes:

Ischemic stroke
About 80 percent of strokes are ischemic strokes. They occur when blood clots or other particles block arteries to your brain and cause severely reduced blood flow (ischemia). This deprives your brain cells of oxygen and nutrients, and cells may begin to die within minutes. The most common ischemic strokes are:
 Thrombotic stroke. This type of stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A clot usually forms in areas damaged by atherosclerosis — a disease in which the arteries are clogged by an accumulation of cholesterol-containing fatty deposits (plaques). This process can occur within one of the two carotid (kuh-ROT-id) arteries of your neck that carry blood to your brain, as well as in other arteries. An ischemic stroke may also be caused by plaques that completely clog or markedly narrow an artery. This narrowing is called stenosis.
 Embolic stroke. This type of stroke occurs when a blood clot or other particle forms in a blood vessel away from the brain, but is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus. It's commonly caused by atrial fibrillation, an abnormal heart rhythm caused by irregular beating in the heart's two upper chambers.
Hemorrhagic stroke
Hemorrhage is the medical word for bleeding. Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Hemorrhages can result from a number of conditions that affect your blood vessels, including uncontrolled high blood pressure (hypertension) and weak spots in your blood vessel walls (aneurysms). A less common cause of hemorrhage is the rupture of an arteriovenous malformation (AVM) — a malformed tangle of thin-walled blood vessels, present at birth. There are two types of hemorrhagic stroke:
 Intracerebral hemorrhage. In this type of stroke, a blood vessel in the brain bursts and spills into the surrounding brain tissue and damages cells. Brain cells beyond the leak are deprived of blood and are also damaged. High blood pressure is the most common cause of this type of hemorrhagic stroke. High blood pressure can cause small arteries inside your brain to become brittle and susceptible to cracking and rupture.
 Subarachnoid hemorrhage. In this type of stroke, bleeding starts in a large artery on or near the membrane surrounding the brain and spills into the space between the surface of your brain and your skull. A subarachnoid hemorrhage is often signaled by a sudden, severe "thunderclap" headache. This type of stroke is commonly caused by the rupture of an aneurysm, which can develop with age or result from a genetic predisposition. After a subarachnoid hemorrhage, vessels may go into vasospasm, a condition where arteries near the hemorrhage constrict erratically, causing brain cell damage by further restricting or blocking blood flow to portions of the brain.

pamuk
10-09-2006, 03:11 PM
Thanks Dawn for the info, it is great to have this info and I didnt realise there were so many causes for a stroke. She has definately had two bleeds and has very little use of her left side, just need to find out what type of bleed it was. Thanks again for taking the time to give me this info

pam from england

Nick
10-09-2006, 03:23 PM
I still dont know what has caused this bleeding from a blood vessel as they put it, I thought that the only cause of bleeding from a blood vessel was an annie but they wont confirm she had an annie, does anyone know if a blood vessel can just bleed say through a tiny weakness that isnt an annie? or if a stroke can be something else rather than a blood clot as I thought it was - the hospital have never said she has had a blood clot, they have always maintained that she has had two bleeds from a blood vessell, and the way they say it makes it sound quite a frequent occurance but it isnt something I have heard of. Also I always thought surgery was automatic after these type of incidents, has anyone had this experience when surgery hasnt been performed?

pam

Dear Pamuk,
I'll will try to help you with understanding of latest events for you.
I am a neurosurgeon from Russia. Spontaneous bleeding or hemorrhage into the brain are synonims for hemorrhagic stroke. It may be provoked by high blood pressure (vessel wall rupture), rupture of the AV malformations in the brain and aneurysm rupture. Anyway, thorough investigation is needed for such diseases diagnosis. MR angiography can resolve sometimes this questions. If doctors will not find any AVM or aneurysms they have to weight all risks of future invasive treatments including surgery. In your case I think they did right. No surgery is required in case of small hemorrhage with positive response to conservative treatment.
Sincerely,
Dr. Nick

Diane118
10-09-2006, 05:52 PM
Pam,

Gee, I knew there were strokes involving a clot and those involving bleeding, but I always thought those were ruptured annies, too! Glad Dawn shared all that information, very helpful. Please keep us informed about your cousin's progress.

I had a minor stroke (clot-type) that brought me to the hospital and then they incidentally found my annie (in a different part of my brain, from where the stroke or infarct was). Luckily, I didn't lose strength or feeling in my left side, just coordination and control. To this day, over 5 years later, I still have some residual problems with the control and coordination in my left hand, but every year, it gets better. Of course, I had occupational and physical therapy (OT & PT) early on. Then, I took up knitting, which I really think has helped me tremendously with my coordination. Oh yes, and of course, typing emails and posting on this board helped me emotionally but also with the use of my left hand!

Do your cousin's doctors think she will recover the feeling and use of her left side? I sure hope so. And even if they don't, we know so many people here that have surpassed the expectations of their doctors, so there is always hope!!

Sending positive thoughts in your direction.

Take care,
Diane

pamuk
10-10-2006, 11:51 AM
Thanks again for everyones help, Dawn it must have taken you a long time to get all that info for me I am really grateful. Nick, it is good to hear from a doctor about this subject and your comments about the treatment are reassuring. Diane, good to hear from you again - they dont know if she will regain any feeling, she made good progress first few days, got her swallow reflex back and her speech improved,she was also completely incontinent at first but then made progress in that area. then instead of having no feeling down her left side she got tingling in her left arm which was all very positive - but for the last week she has just stayed the same and the depression and frustration has kicked in - she is getting very bad tempered with the nurses, fortunately they understand her frustration and manage to calm her down. She has only a slight tingling in her left arm, eveything else on the left is paralysed. She has had intensive physio since the start, the doctors dont know yet how much feeling she will regain. The plan at the moment is for the physiotherapists to get her to her maximum potential, then she will go to a rehab unit.

Bye for now

pam