some questions answered

What are they doing to help her in addition to the daily angiograms?

This is a photo on mom’s IV pole not even at its fullest. There are so many intravenous medications that she is given on a daily basis. In addition to regular IV fluids she is getting Magnesium Sulfate to open up collateral circulation and relieve ischaemia (a restriction in blood supply), mannitol, many different antibiotics including Vibramycin, quite a few different vitamins (iron, b12) and on this pole you can see that she is also getting her blood transfusion. This is also where they hang her nourishment for her feeding tube. There are many other things that I just don’t know or understand but you can see that she is getting a multitude of things to try to help her get better.
What is the angiogram steroid?
Okay so I have more information on the daily treatments that mom is getting. The type of spasm that she is having in her arteries is called vasospasm. The treatment that she is getting is an infusion for vasospasm called intra-arterial verapamil. Verapamil is the name of the medicine that is being administered directly into the artery through the angiogram. I know that I explained this but I wanted to give the drug information.

Is the Verapamil working?
Her angiogram is showing that she is still demonstrating spasm but that some parts are slowing and getting stronger. Overall she is not getting worse and hasn’t exhibited any new bleeds. This is good news!

How much is and will she progress?
Each day she is still progressing and getting stronger, however, when you look day to day her progress is slow. That is what they keep telling us is that this is a long road to recovery. Treatment for this condition is long-term and may have significant risks. Many months may need to pass before one can tell what degree of recovery will ultimately occur. We are just relieved to see minimal progress each day, however small- progress is progress in our book.

What is Vasculitis?
Vasculitis (meaning inflammation of the blood vessels) confined to the brain, the spinal cord and its covering is referred to as central nervous system vasculitis. Central nervous system (CNS) vasculitis is a rare disorder. Central nervous system vasculitis can be classified as primary (primary angiitis of the central nervous system or PACNS) when there is no other disease or condition present that may cause blood vessels to be damaged.

Why steroids?
This disease is often treated with a short course of glucocorticoids as well as other drugs such as calcium channel blockers that relax “tight” blood vessels. Such a powerful combination of drugs is used because without them this disease is nearly always fatal. With successful therapy, patients may have partial or complete recovery. Unfortunately, the brain is an organ that has a very limited potential to regenerate itself. Thus, if a patient has experienced a massive stroke, he or she will continue to suffer the deficit of that stroke even if the vasculitis is successfully treated.

What is the neuro drain for?

A ventriculostomy is a tool to measure the pressure in your head called intracranial pressure (ICP). It is important that this ICP was inserted because it helps not only to drain the extra cerebrospinal fluid and excess blood but also measures the pressure in her brain. Keeping the excess fluid out reduces the pressure. Three days a week they are testing the cerebrospinal fluid (CSF) for infection (I am sure they are testing it for other things as well).

http://www.upstate.edu/uhpated/pdf/ventriculostomy.pdf