Recovery After Aneurysm Rupture: A Daughter's Concern

Ruptured cerebral aneurysm

I would like to ask about my mother.
On October 20, 2016, she fell into a coma due to a ruptured cerebral artery, with a Glasgow Coma Scale score of 3 at that time.
After surgery and the placement of a drainage tube, she was discharged in January and has been cared for at home.
My mother currently has a tracheostomy tube, a nasogastric tube, and a urinary catheter.
She has now recovered to a Glasgow Coma Scale score of 9.
Although she can blink her eyes and shows some motor response when touched, she is also able to exert slight movement in her cervical spine.
When I talk to her, she blinks in response, and if I ask her to blink a few times, she complies.
The doctor mentioned that her brain was not damaged at all.
However, it has been almost six months now, and I feel her recovery is quite slow.
Last month, we identified the cause of her condition, and the doctor said it was due to hydrocephalus, which is causing her slow recovery.
A second drainage tube has been placed in her brain, but her condition still shows little progress.
We take her for rehabilitation three days a week, using a stationary bike and a standing frame.
I would like to know if it is normal for my mother’s recovery to be so slow after almost six months.
I really hope she can wake up and recover soon!

Lizi, 20~29 year old female. Ask Date: 2016/04/08

Dr. Zhang Junwei reply Neurosurgery

Brain injuries are very complex.
Once a person has experienced a severe coma with a Glasgow Coma Scale score as low as three, to be honest, no one can predict when they will wake up!

Reply Date: 2016/04/08

More Info

The recovery process following a brain aneurysm rupture can be complex and varies significantly from patient to patient. Your mother’s situation, as you described, involves a significant medical history, including a coma with a Glasgow Coma Scale (GCS) score of 3, surgical intervention, and ongoing rehabilitation efforts. It is understandable that you are concerned about her slow recovery, especially after nearly six months of care and rehabilitation.

Firstly, it is important to recognize that the brain is a highly intricate organ, and recovery from severe injuries or conditions like an aneurysm rupture can take a considerable amount of time. The GCS score you mentioned indicates the level of consciousness and responsiveness. A score of 9 suggests that your mother is in a state of altered consciousness, which can be a positive sign compared to her initial score of 3. The fact that she can blink in response to commands and exhibit some movement is encouraging, but it is also common for recovery to be gradual and non-linear.

The presence of hydrocephalus, or accumulation of cerebrospinal fluid in the brain, can indeed complicate recovery. This condition can lead to increased intracranial pressure and may affect cognitive function and responsiveness. The placement of a second drainage tube indicates that the medical team is actively managing this issue, which is crucial for her recovery. It is essential to monitor her condition closely, as managing hydrocephalus can significantly impact her overall prognosis.

Rehabilitation plays a vital role in recovery after a brain injury. The fact that you are taking her for rehabilitation three times a week is commendable and can help improve her physical capabilities over time. Rehabilitation often includes physical therapy, occupational therapy, and speech therapy, which can aid in regaining strength, coordination, and cognitive function. However, progress can be slow, and it is not uncommon for patients to experience plateaus in their recovery.

In terms of what is considered "normal" recovery, it is essential to understand that each patient's journey is unique. Factors such as age, overall health prior to the injury, the extent of the brain injury, and the presence of complications like hydrocephalus can all influence recovery time. While some patients may show significant improvement within months, others may take much longer to regain function. It is also important to note that recovery can be a long-term process, sometimes extending over years.

As a daughter, it is natural to feel anxious and hopeful for your mother's recovery. It may be beneficial to maintain open communication with her medical team. They can provide insights into her specific case, potential timelines for recovery, and adjustments to her rehabilitation plan based on her progress. Additionally, consider seeking support for yourself, as caring for a loved one with a severe medical condition can be emotionally taxing.

In conclusion, while it is understandable to be concerned about your mother's slow recovery, it is essential to remain patient and hopeful. Recovery from a brain aneurysm rupture is often a gradual process, influenced by many factors. Continue to support her rehabilitation efforts, and keep in close contact with her healthcare providers to ensure she receives the best possible care. Your dedication as a daughter is invaluable in this journey, and every small sign of progress is a step toward recovery.

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