Need advice regarding Cerebral Haemorage?

Question

I just received email from my friend in India whose my mother had an extensive cerebral haemorrhage in the basal ganglia on Jan 19th and has ever since then been in the medical ICU in New Delhi, and on a ventilator since the first week of Feb. She conscious and responsive, but not able to speak partly because of a tracheostomy done to facilitate ventilation and aspirate secretions caused by probable lower respiratory tract infection. She has also survived a bout of Pseudomonas.

Currently there is a lot of trouble weaning her from the ventilator. She can breathe upto 24 hours
without the ventilator, but then gets exhausted (heart rate went up to 168 one time) and the ventilator has to be re-applied for 12 to 18 hours before efforts are made again to get her to breathe without it.

My friend found that doctors in India, even the better practitioners, are not fully cognizant of some medications that are regarded as fairly basic in the US and Europe for the treatment of certain

conditions. Among these are supportive medications formulated to help fortify patients suffering from certain severe conditions.

My friend needs advice regarding the medications that are given to cerebral haemorrhage victims for

1) slowly-resolving hemorrhages
2) help in weaning the patient from the ventilator especially if their respiratory muscular effort is
poor,
3) as supportive therapy
4) as miscellaneous care.

Could some knowledgeable person reply to these 4 points or point to some helpful links

Thanks

Answer 1

To be honest, speak to the consultant, these four questions of yours are highly practically orientated, volumes of books are written on it , it requires a team work of different consultants.

Answer 2

That is kind of scary because all our doctors here are from India.

My grandmother was on a ventilator and eventually I made them take her off of it. We gave her oxygen and she was fine we did not have to wean her off; she was really happy to get rid of the trache. Maybe they can put the oxygen tube around her nose like they did for my grandmother.

http://en.wikipedia.org/wiki/Cerebral_hemorrhage
http://www.csmc.edu/2424.html

http://www.answers.com/topic/cerebral-hemorrhage

Answer 3

meds they usually use a inert sugar like maldextrin or manitol to decrese the swelling, or they do surgery to drill holes to drain the swelling. usually due to bleeding in the brain cavity.
other meds are to support or supress her body fuctions. some meds keep her heart going fast enough. some meds keep her sedated enough to keep the breathing tube in place and the ventilator going. she obviously cant breath well enough on her own yet.

but its delicate cuz sometimes the meds work to reduce swelling, sometimes they have to operate. if she is still bleeding, the prognosis is not good anyway.