Outcomes in brainstem stroke what is in the patients best interests


Q: My great-aunt had a massive stroke from the brainstem. The doctors are asking her son to pull the plug. We are unabe to come to a decision.

After a stroke like this, how will it affect the quality of life


A:   Most patients with brainstem or vertebrobasilar stroke have a significant degree of disability, due to involvement of the brainstem and cerebellum, with resultant multisystem dysfunction (eg, paralysis of 2 or more limbs, difficulty swallowing, difficulty speaking, and visual disturbances). They often require ongoing, acute rehabilitation, with attention paid to specific patient issues and the formulation of short-term and long-term care plans. The rehabilitation and planning are performed best in a multidisciplinary and interdisciplinary setting. Decisions regarding end of life issues should be discussed with the attending physician in conjunction with family members, to determine what is in the patients best interests.

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