Post-Surgery Recovery: What to Expect After Neurological Trauma

Will the current condition improve after the surgery?

Dr.
Chang, I am really worried about my brother's condition.
He is three years old and had a fever that led to polio; he could still walk with crutches.
On the morning of the sixth day of the Lunar New Year, he was going to work when he accidentally fell down the stairs at home, which were wet due to the south wind.
He thought he was fine and got up to go to work.
In the afternoon, my mother noticed he seemed unwell and immediately called an ambulance to take him to Annan Hospital.
A CT scan showed internal bleeding and brain tissue damage.
He was hospitalized on February 13 and underwent four surgeries over the course of a month.
After spending more than a month in the intensive care unit, he was transferred to a regular ward and discharged on April 8, seemingly able to care for himself as he did before the injury.

However, just a few hours later, the next morning, he was found to be having seizures, and we immediately called an ambulance again.
He was readmitted to the ICU and then to a regular ward, where it was discovered that he could no longer stand and his mental state was not normal.
Although he was speaking incoherently, he still recognized us.
He was discharged home on May 2, unable to walk but still able to use a walker with some strength in his hands.
He could still eat and feed himself, but now he speaks very softly, has lost strength in his hands, and his condition seems to be deteriorating day by day.

What exactly is wrong with him? What will his condition ultimately become? How should we care for him? I have hired a caregiver to look after him, but we don't have the money for this to be a long-term solution.
My mother wants to send him to a nursing home, but I can't bear to part with him.
He has a fifth-grade daughter and a first-grade son.
I really can't bear to think about the future.
Dr.
Chang, what is the likely outcome for my brother in this situation? How should our family care for him in a way that would be helpful?

Jingwen, 40~49 year old female. Ask Date: 2016/07/03

Dr. Zhang Junwei reply Neurosurgery

The situation is complex, and without clinical examinations and CT scan images, it is really difficult to answer your question.
I recommend consulting at an outpatient clinic!

Reply Date: 2016/07/03

More Info

I'm sorry to hear about your brother's situation. It sounds incredibly challenging for both him and your family. Understanding post-surgery recovery, especially after neurological trauma, can be complex and often varies greatly from person to person. Here’s a comprehensive overview of what to expect and how to support him during this difficult time.

Understanding Post-Surgery Recovery
1. Initial Recovery Phase: After a significant neurological injury, such as a traumatic brain injury (TBI), the initial recovery phase is critical. This phase can last from days to weeks and involves monitoring for any complications, such as seizures, which your brother has experienced. The brain is very sensitive after trauma, and it may take time for swelling to decrease and for the brain to stabilize.

2. Neurological Assessment: Regular neurological assessments are essential. This includes monitoring his level of consciousness, cognitive function, and motor skills. The Glasgow Coma Scale (GCS) is often used to assess consciousness levels. Your brother's fluctuating mental state and ability to recognize family members indicate that he is in a recovery phase, but it may take time for him to regain full cognitive function.

3. Physical Rehabilitation: Given that your brother has experienced mobility issues, physical therapy will be crucial. Rehabilitation can help improve strength, coordination, and balance. The fact that he can still use his hands is a positive sign, and with the right therapy, he may regain more function over time. Encourage him to participate in physical therapy sessions, as they are tailored to his specific needs and can significantly aid recovery.

4. Speech and Cognitive Therapy: Since he is experiencing difficulties with speech and cognitive function, speech therapy may be beneficial. Speech therapists can help him regain his ability to communicate effectively and improve cognitive skills. This therapy often involves exercises to strengthen the muscles used in speech and strategies to enhance cognitive processing.

5. Emotional and Psychological Support: The psychological impact of a traumatic brain injury can be profound. It's not uncommon for individuals to experience mood swings, anxiety, or depression following such trauma. Providing emotional support and considering counseling or therapy can be beneficial for both your brother and your family. Engaging with support groups for families dealing with similar situations can also provide comfort and shared experiences.

6. Home Care and Environment: Creating a supportive home environment is crucial. Ensure that his living space is safe and accessible. Consider modifications that can help him navigate his surroundings more easily, such as removing tripping hazards and ensuring that essential items are within reach.
7. Long-Term Outlook: Recovery from neurological trauma can be a long process, and outcomes can vary widely. Some individuals may experience significant improvements over months or even years, while others may face ongoing challenges. It's essential to maintain realistic expectations and celebrate small victories along the way.

8. Family Involvement: Your role as a family member is vital. Being present, encouraging him, and participating in his rehabilitation can make a significant difference in his recovery. Your emotional support will be crucial as he navigates this journey.

Conclusion
While the road to recovery may be long and filled with uncertainties, many individuals do improve over time with the right support and rehabilitation. It's essential to stay hopeful and proactive in seeking the best care for your brother. Regular communication with healthcare providers will help you understand his progress and adjust care plans as needed. Remember, recovery is often a gradual process, and every small step forward is a victory. Your love and support will be invaluable to him during this challenging time.

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