Cerebral clot

(((((Jenac)))))

I'm so sorry to hear about your dad.

Not knowing anything about your dad's medical history, age, etc., it is difficult to know why TpA wasn't used, however, if he was over 4 hours into the stroke (4 hrs. from onset of symptoms), there is already permanent damage done. TpA then becomes dangerous to use, because of the tissue necrosis in the region of the stroke, and greater chance of bleeding into the area. You then have a much sicker patient--hemorrhagic on top of embolic stroke, and the prognosis isn't nearly as good.

I don't know where you are located in Ohio, but if he is in one of the tertiary care centers like University Hospitals or Cleveland Clinic, they have protocols in place to ensure that a workup is done to try to determine source of the embolus. Diabetes is right up there on the list of contributing factors for stroke, as is carotid stenosis, atrial fib., as well as a number of other diseases. No doubt he will have carotid duplex scanning and a 2D Echo, in addition to lots of labwork to help identify other potential risk factors.

It sounds like they are already doing all the appropriate stuff with initiation of rehab. Since he has no gag and is aphasic, I assume they are feeding him enterally. He has a long and challenging road ahead, and so will you and your family. I wish you lots of patience--it's not easy being the nurse and the daughter!

Good luck, and feel free to pm me anytime.

I do not have any experience in this type of problem, but I do want to say that I'm sorry your family is going through such an ordeal. (((((((hugs)))))))

I am not sure if the same goes for a pulmonary embolism but I had 2 of those I was not given clot busters because it had been too long. I was started on heparin a full workup to see if I had a clotting disorders. The doctor told me with blood clots the heparin is used to prevent more clots but also so that the clot does not grow and then the body has time to break the clots down again I am not sure if it is the same when they go to the brain. I really hope your dad gets better I will be praying.

All the best with your situation, Jen.

Hope the rehab works well and Dad achieves an optimal recovery.

Thank you all for the info. and the support. Time will tell how bad it really is going to be. But he's a fighter-and he's trying so hard to work through it...

Sorry to hear about your dad. After he goes to rehab, he will be taken off the heparin and probably placed on aggrenox or plavix. The neurologist that I work with seems to use aggrenox for almost all of his post stroke patients. Strokes are tough because at this point there is so little that can be done, it turns to preventing another stroke, managing symptoms, and lots of hard work to try to regain some of ADLs. I hope that you dad is recovering well.