Can Brain Hemorrhage Stroke Patients Recover Without Surgery?

Q: Can Brain Hemorrhage Stroke Patients Recover Without Surgery?

Hello： <br>1. <br>Continuous rehabilitation is necessary to prevent complications from stroke, such as pressure ulcers and muscle spasms. <br>The rehabilitation process must be uninterrupted to avoid prolonged pressure on the affected limb and to reduce the likelihood of spastici

Will a hemorrhagic stroke recover on its own?

Hello Doctor: I previously inquired about the issue of hemorrhagic stroke, and since the patient is over 80 years old, surgery was not recommended.
The patient's condition is now stable and has been discharged for home care.
Although the patient is paralyzed and bedridden, they are alert and able to recall past events, but still require feeding through a nasogastric tube.
I would like to ask the doctor: 1.
I heard from the caregiver that for hemorrhagic stroke, if it involves small blood vessels, it may gradually recover on its own? (The patient does not have chronic diseases and all organs are functioning well.) Is it really possible for recovery? 2.
It is very easy for the patient to choke while being fed through the nasogastric tube; what could be the reason for this?

Didi, 60~69 year old female. Ask Date: 2014/09/16

Dr. Xie Bojun reply Neurosurgery

Hello:
1.
Continuous rehabilitation is necessary to prevent complications from stroke, such as pressure ulcers and muscle spasms.
The rehabilitation process must be uninterrupted to avoid prolonged pressure on the affected limb and to reduce the likelihood of spasticity.
2.
If the patient experiences coughing during feeding and the feeding is stopped, please first confirm the correct placement of the nasogastric tube or perform a backflow of gastric contents before each feeding to verify its position.
If the position is correct and coughing persists, consider other potential causes: 1.
aspiration of saliva, 2.
gastroesophageal reflux, 3.
incorrect feeding posture.
Changhua Hospital cares about you.

Reply Date: 2014/09/16

More Info

Brain hemorrhage, particularly in the context of a stroke, presents a complex clinical scenario that requires careful management and consideration of the patient's overall health status. In the case of an elderly patient, such as the one you described who is over 80 years old, the decision against surgical intervention is often based on a variety of factors, including the patient's age, overall health, and the specific characteristics of the hemorrhage.

1. Recovery Without Surgery: It is indeed possible for patients with brain hemorrhages, particularly those involving smaller blood vessels, to experience some degree of recovery without surgical intervention. The brain has a remarkable ability to adapt and reorganize itself, a phenomenon known as neuroplasticity. In cases where the hemorrhage is small and the surrounding brain tissue is not severely damaged, the body may gradually reabsorb the blood, and the affected areas may heal over time. This process can lead to improvements in function, especially if the patient is otherwise healthy and does not have significant comorbidities. However, the extent and speed of recovery can vary widely among individuals. Factors such as the location of the hemorrhage, the patient's age, and their pre-existing health conditions all play a crucial role in determining the potential for recovery.

2. Nasal Gastric Tube Feeding and Aspiration Risk: The use of a nasogastric (NG) tube for feeding can indeed pose risks, including aspiration. Aspiration occurs when food or liquid enters the airway instead of the esophagus, which can lead to serious complications such as pneumonia. In patients with neurological impairments, the swallowing reflex may be compromised, making it more difficult for them to safely swallow food or liquids. This can be due to weakened muscles involved in swallowing or altered consciousness, which can affect the coordination of swallowing.
To mitigate the risk of aspiration, it is essential to monitor the patient's swallowing ability closely. Speech and language therapists can perform assessments to determine the safest methods for feeding and swallowing. If the patient is able to participate in therapy, they may benefit from exercises designed to strengthen the muscles involved in swallowing. Additionally, modifying the consistency of food and liquids can help reduce the risk of aspiration. For example, thickening liquids can make them easier to control during swallowing.

In summary, while recovery from a brain hemorrhage without surgery is possible, it is highly individualized and depends on various factors. Continuous rehabilitation and supportive care are crucial in maximizing recovery potential. As for the challenges associated with NG tube feeding, working closely with healthcare professionals, including speech therapists and dietitians, can help manage these risks effectively. Regular follow-ups and assessments will be vital in adjusting care plans as the patient's condition evolves.

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