How Long for Complete Absorption of Blood Clots After Stroke?

The complete absorption of a hematoma from a hemorrhagic stroke can take several weeks to months, depending on various factors such as the size of the hematoma, the individual's overall health, and the body's healing response?

Hello doctor, my father is 64 years old.
On the evening of February 11, he suddenly experienced urinary incontinence, weakness on the right side, and was unable to stand or speak.
After being taken to the emergency department at Taipei Medical University, a CT scan was performed, and he was diagnosed with a moderate left cerebral hemorrhage, specifically "left basal ganglia hemorrhage." He stayed in the intensive care unit for three days.
How long should we wait before performing another CT scan to see if the bleeding has decreased? How long does it typically take for intracranial pressure to stabilize? The doctor mentioned that this has affected his speech and caused complete paralysis on the right side.
If he undergoes rehabilitation, is there a chance for significant improvement? Will this affect his memory? Currently, he can only say a few simple words and his speech is unclear.
The hospital has advised us to prepare for a transfer to another facility for rehabilitation.
Some have suggested that going home might be better, as we could go to the hospital for daily rehabilitation.
However, what if he suddenly relapses at home? As a son, this is a difficult choice.
I am considering transferring him to another hospital for inpatient observation, rehabilitation, and acupuncture.
Would this be a better option? We need to prepare for the transfer this week, and I think finding a hospital closer to home would be more convenient (we live near Taipei Medical University).
Before discharge or transfer, he will likely still be unable to walk.
How long might it take before he can walk again? I heard that a hospital stay is limited to 28 days, after which he would need to transfer to another hospital.
Wouldn't that just prolong the process? After two weeks at the next hospital, we would have to look for another facility again.
What if the hospital does not accept him? Generally, how long should a hospital stay be for optimal recovery?

Mr. Lin, 30~39 year old female. Ask Date: 2018/02/25

Dr. Zhang Junwei reply Neurosurgery

Sir, the questions you asked are quite comprehensive.
I cannot answer them solely based on a basal ganglia hemorrhage; I need to review the complete CT scan and conduct a thorough physical assessment of the patient.
I apologize.

Reply Date: 2018/02/25

More Info

After a stroke, particularly one involving a brain hemorrhage, the recovery process can be complex and varies significantly from patient to patient. In your father's case, he experienced a left-sided brain hemorrhage, which has led to right-sided weakness and speech difficulties. Here are some insights regarding your questions:
1. Time for Blood Clot Absorption: Typically, blood clots from a brain hemorrhage can take anywhere from 2 to 6 weeks to fully absorb. The exact duration depends on various factors, including the size of the clot, the patient's overall health, and the body's healing response. In your father's case, since the hemorrhage is described as moderate, you might expect the absorption process to be closer to the 4-6 week mark, but this can vary.

2. Recovery of Function: Once the blood clot is absorbed, the symptoms of weakness and loss of control may improve, but recovery is not guaranteed. The damage caused by the hemorrhage itself can lead to lasting neurological deficits. The brain's ability to recover depends on the extent of the damage and the effectiveness of rehabilitation. While some patients experience significant recovery, others may have persistent issues. It is crucial to engage in rehabilitation therapies as soon as possible to maximize recovery potential.

3. Follow-Up Imaging: It is common practice to conduct follow-up imaging, such as a CT scan, to monitor the status of the hemorrhage and assess any changes. This is typically done within a few days to a week after the initial scan, depending on the clinical situation. Your father's medical team will determine the appropriate timing based on his condition and progress.

4. Rehabilitation and Quality of Life: Rehabilitation plays a vital role in recovery after a stroke. If your father engages in a structured rehabilitation program, there is a possibility of regaining some functions, including mobility and speech. However, it is essential to set realistic expectations; while many patients can regain significant independence, complete recovery to pre-stroke levels is often not achievable. The extent of recovery will depend on the severity of the brain injury and the effectiveness of rehabilitation efforts.

5. Choosing Between Hospitals: The decision to transfer your father to another hospital for rehabilitation should consider several factors, including the quality of the rehabilitation program, proximity to home, and the availability of specialized care. If the new facility offers a comprehensive rehabilitation program that includes physical therapy, occupational therapy, and speech therapy, it may be beneficial. However, ensure that the facility is equipped to handle potential complications and has a good track record in stroke recovery.

6. Duration of Hospital Stay: The length of stay in a rehabilitation facility can vary widely. Generally, patients may stay from a few weeks to several months, depending on their progress. The goal is to maximize recovery before transitioning to outpatient therapy or home care. If your father requires ongoing support, it may be necessary to explore options for home health care or outpatient rehabilitation after discharge.

7. Concerns About Recurrence: It is understandable to be concerned about the possibility of a recurrence of symptoms. Continuous monitoring and adherence to medical advice are crucial. If your father shows any signs of deterioration, such as increased weakness, confusion, or changes in consciousness, it is essential to seek immediate medical attention.

In conclusion, navigating the recovery process after a stroke can be challenging, but with appropriate medical care, rehabilitation, and support, many patients can achieve significant improvements in their quality of life. It is essential to maintain open communication with your father's healthcare team and actively participate in his rehabilitation journey.

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