Post-Surgery Mental Health Issues After Aneurysm Rupture: Insights and Concerns

Postoperative Mental Status after Aneurysm Rupture Surgery

Hello, doctor.
My mother is 61 years old.
On August 6th of this year, she suddenly fainted and was taken to the nearest Cathay General Hospital for emergency treatment.
The doctors diagnosed her with a ruptured aneurysm, and she had two aneurysms.
After surgery (the clipping type), although one of her eyes has suffered some vision damage, she was able to be discharged on September 19th and is now resting at home.
Her limbs have recovered well, but she is experiencing cognitive issues and her consciousness is not very clear.
She has episodes of disorientation and fears that others may harm her.
She also believes that the food she eats may be poisoned.
I would like to ask the doctor if this is due to brain nerve damage from the bleeding or if it is postoperative delirium.
She has been on medication from a psychiatrist for three months now, but her condition has not improved.

Yan Zhang, 20~29 year old female. Ask Date: 2016/11/13

Dr. Zhang Junwei reply Neurosurgery

It should be the result of a brain injury caused by bleeding.

Reply Date: 2016/11/13

More Info

Post-surgery mental health issues following an aneurysm rupture can be complex and multifaceted. In your mother's case, it appears that she is experiencing significant cognitive and psychological challenges after her surgery. These issues can stem from a variety of factors, including the direct effects of the aneurysm rupture, the surgical intervention itself, and the subsequent recovery process.

Firstly, it is important to understand that an aneurysm rupture can lead to various neurological deficits due to the bleeding and pressure on brain tissues. This can result in cognitive impairments, such as confusion, memory problems, and difficulties with spatial orientation. The fact that your mother is experiencing disorientation and time-space confusion suggests that her brain may still be recovering from the trauma of the rupture and the surgical procedure. Cognitive rehabilitation may be beneficial in this context, as it can help patients regain lost skills and improve their cognitive function over time.

Moreover, the psychological symptoms your mother is experiencing, such as paranoia and fear of being harmed, could be indicative of post-operative delirium or a more persistent condition known as post-traumatic stress disorder (PTSD). Delirium is a common complication after major surgeries, particularly in older adults, and can manifest as confusion, agitation, and altered consciousness. It is often temporary but can be distressing for both the patient and their family.

The fact that your mother has been on psychiatric medication for three months without significant improvement raises concerns about the adequacy of her treatment plan. It may be worthwhile to revisit her psychiatric evaluation to ensure that her symptoms are being addressed appropriately. Sometimes, a combination of medications or a different class of drugs may be necessary to achieve better results. Additionally, therapy, such as cognitive-behavioral therapy (CBT), can be beneficial in helping her cope with her fears and anxieties.

Another important aspect to consider is the role of family support and rehabilitation in her recovery. Engaging her in cognitive exercises, social interactions, and physical activities can help stimulate her brain and improve her overall mental health. Encouraging her to participate in activities she enjoys, while also providing a safe and supportive environment, can foster a sense of normalcy and reduce feelings of paranoia.

It is also essential to monitor her physical health closely, as any underlying medical issues, such as electrolyte imbalances or infections, can exacerbate cognitive and psychological symptoms. Regular follow-ups with her healthcare team, including neurologists and psychiatrists, are crucial to ensure that her recovery is on track and that any emerging issues are addressed promptly.

In summary, your mother's post-surgery mental health issues are likely a combination of the effects of the aneurysm rupture, the surgical intervention, and the psychological impact of her condition. A comprehensive approach that includes medical evaluation, psychiatric care, cognitive rehabilitation, and strong family support will be vital in helping her navigate this challenging recovery process. It is important to remain patient and proactive in seeking the best care for her as she continues to heal.

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