Frontal Lobe Stroke????

DavezWife

Uuugggghhhh.

 Update on my dad:

Well, in short, we're all still confused and he's still in the ICU.

 

Each day has been getting better than the last - less confusion (still very constant, though) and he's been getting up into the chair, etc a little bit. Pain meds and the sedation have been less, but he's still goofy as heck, and often talks in jibberish or gets real angry, real quick. They all agree his case is complex, nothing seems to make sense.

 

However, another set back today with ANOTHER  possible med interaction, and now the docs are suspecting it's been a small "frontal lobe stroke" or bleed all along.

 

Although they've done a CT scan earlier on and a spinal tap, they're going to do an MRI tomorrow to check his brain in detail. We're anxious for some concrete medical explanations at this point, so please keep all things crossed and prayers said if you say them, that things are a bit more clear for us all tomorrow.

If you by chance know anything about frontal lobe strokes, please share. I have had a few patients in my days with front lobe dementia (lewy-body, etc) and the "side effects" are VERY VERY similar with my dad right now. Although I would never want my dad to have had a stroke, it would be nice to have some medical answers!

Thanks for all your emails, msgs and such. I'm lurking, but trying to give Ava 100% of my attention when I'm not standing bedside 'me dad.

Courted

((((HUGS))))  I know nothing about frontal lobe strokes, but understand the functions of the frontal lobe, so I can imagine how scary that could be.  I am happy he seems to be better, but it still seem like a very sad situation.  I pray you all get some answers tomorrow and that those answers will help guide your dad to more healing.

desabean

I have no experience but I agree that having the answer (and especially if it is a stroke since there is so much that can be done to counteract the damage-- both of my parents have had strokes-- my mom a moderate one and I doubt anyone would be able to tell anymore).

I hope you get some answers soon but more importantly I hope he continues to improve and can get out of ICU soon.  Hang in there!!

here4u

Sounds like they are looking into everything possible, but the mood changes can indicate something with the brain.  I hope the MRI can tell you whats going on  

Germanwife2b

Well crap.  I was hoping to see better news.  It would make sense about a frontal lobe stroke based on all of the things you have told me.  The frontal lobe controls all of that personality stuff.  Keep us updated.  This really sucks that you all are going through this.  I will continue to keep him in my thoughts and prayers.

leslie&brian

I use to work on a neuro unit, and know that frontal lobe strokes can often times be silent, as in the patient doesn't have the most obvious signs of a stroke (ie. slurred speech, paralysis of one side, droopy face, etc). Symptoms will differ depending on if it's the dorsal part of the frontal lobe, the medial part, etc.

In my experience, pt's with a frontal lobe stroke will have a lot of imitating behaviors, they'll perseverate on certain things, have a labile mood, and lack inhibition. 

Picks dementia patients have issues with their frontal lobe, and they usually present with extreme changes in behaviors, and some can be very sexually inappropriate, and just say the first thing that comes to mind. I'm pretty sure that Lewy Body effects more of the cortex of the brain. 

In any case, I hope that you find some concrete answers tomorrow. I know that this has to be extremely taxing, and I will keep your dad and your family in my thoughts and prayers. 

Mrs.Reem

You all will be in my thoughts. I can't even imagine how scary and frustrating this must be.

armywife76

leslie&brian:

I use to work on a neuro unit, and know that frontal lobe strokes can often times be silent, as in the patient doesn't have the most obvious signs of a stroke (ie. slurred speech, paralysis of one side, droopy face, etc). Symptoms will differ depending on if it's the dorsal part of the frontal lobe, the medial part, etc.

In my experience, pt's with a frontal lobe stroke will have a lot of imitating behaviors, they'll perseverate on certain things, have a labile mood, and lack inhibition. 

Picks dementia patients have issues with their frontal lobe, and they usually present with extreme changes in behaviors, and some can be very sexually inappropriate, and just say the first thing that comes to mind. I'm pretty sure that Lewy Body effects more of the cortex of the brain. 

In any case, I hope that you find some concrete answers tomorrow. I know that this has to be extremely taxing, and I will keep your dad and your family in my thoughts and prayers. 

Ditto this. Holy crap, T. I'm so, so sorry. I know CT's can be a few days behind in picking up a bleed. Peri-op strokes happen fairly often, I'm afraid. Make sure they get rehab (especially ST and OT but also PT) in as soon as he can tolerate activity and stimulation. Hoping it's just the med reaction, but even if it's a stroke, with intensive rehab he can make amazing progress. Frontal lobe is the personality and behavior center so it affects all associated responses. Hope they have some answers soon.

DavezWife

leslie&brian:

In my experience, pt's with a frontal lobe stroke will have a lot of imitating behaviors, they'll perseverate on certain things, have a labile mood, and lack inhibition. 

Picks dementia patients have issues with their frontal lobe, and they usually present with extreme changes in behaviors, and some can be very sexually inappropriate, and just say the first thing that comes to mind.

this. is. my. dad. right. now.

OMG, the nasty mouth on that dude. My ears hurt from what I've heard. And that's NOT him. He's started to imitate more lately, b/c he's not snowed. Very animated face sometimes, again, not typical. Perseverate? um, yeh. Time to go home. NO idea that he can't. Does not CARE why. DOES NOT get that he can't even stand up, and thinks he can drive. Like, for real.  

I distracted him bigtime with bringing up old Irish tales he's told a 200 times over the years. He'll stay on the tangent, and get the "key players" names in, but throws in a lot of not-make-sense details. But still gets from beginning to middle to end.

Kinda.

Man, I hope whatever this is, he is able to recover. If we're dealing with a dad that has permanent deficits this early on in his "grey years" (he's a young 62) we're hosed. Just hosed.

I'll update tomorrow when I can. thanks ladies. you're the best.

 

 

gringa78

The frontal lobe controls impulsivity and social skills, so these things could be affected...however, people regain a lot of skills in the 6 weeks after a stroke, so don't judge affected abilities right now - they will most likely improve.  Take advantage of any therapies they offer him - the brain can be retrained and new pathways can be established.

 I'm sorry you're going through this.  ((HUGS))

DavezWife

gringa78:

The frontal lobe controls impulsivity and social skills, so these things could be affected...however, people regain a lot of skills in the 6 weeks after a stroke, so don't judge affected abilities right now - they will most likely improve.  Take advantage of any therapies they offer him - the brain can be retrained and new pathways can be established.

 I'm sorry you're going through this.  ((HUGS))

are we talkin', like, he could drive again, work, etc. ?

 

-----------------------------------

the only frontal lobe stroke guy I've known did not have a very good recovery. Of course, I don't know where he started from post-stroke.

I will share a cute sidebar: when I was in nursing school, we learned about strokes, etc and that they people can often hear you, see you, etc. and just not be able to respond to get the words out. So as caregivers, let them know what you're doing, and recognize they're "in there."  Well, I had this lady, who recently had HAD a stroke, and I was with her those 1st couple of days. Once she grabbed my shoulder with her dominent side, and looked into my eyes like she was SCREAMING!  I'll never forget that gaze. I looked at her back. held her hand, and said "Betty, I KNOW you're in there. We all know that. You've had a stroke, and we're working on getting you better. We are not giving up on you. I promise."  She relaxed, and after that shirt, that was pretty much the end of seeing her.

Flash ahead YEARS, and I'm in the same small part of town, and some lady, with a slight limp, is coming after me, yelling "Hey! excuse me! Lady!" to me in the grocery store. Ends up it was Betty - SHE RECOGNIZED me, and was able to thank me for that moment we had in the hospital. One of my more special moments as being a nurse. Still to this day.

kimarino13

No advice, just a hug.  I hope your dad makes a full recovery!

yankee42

crap lady im sorry to hear this..very very sorry..i hope so much this is something that he can make a COMPLETE recovery from and you and he can finally go home for real 

sweetpea18

If it is a stroke, his rehab might be tricky. He needs the pt for his knee. (he had a knee replacement that started this all, right?). But, as he gets stronger, he's going to think he can do more than he can. He'll be impulsive, very unsafe and he'll perseverate on random crap. You need to get speech therapy in there stat to start working on his cognition. This will hopefully help with his behaviors, too. And I'm sorry that you're having to deal with all of this. Sometimes, it's worse when you work in the medical field. You know too much.

mechanicsgirl

(hugs) I don' tknow anything about it, but my thoughts are with you.

JM1977

Thinking of you and your family.  (((HUGS)))

emmyloustu

Thinking of you and your dad. Big, big hugs and lots of good wishes for a full recovery!

njdcgirl

Sh!t T. Sorry you are going through all this. It sounds scary and must be frustrating not to have a dx. I hope what ever answers you get your dad is able to make a great recovery. ((hugs))

macschic

The MRI will be helpful to determine stroke vs a Frontotemporal dementia. I believe the clinical picture would also be somewhat different. For example, FTD is insidious onset that gradually becomes worse over time.

 

 

macschic

(((hugs))) Sorry you are going through this:(

DavezWife

update fri afternoon - the neurologists wants to wait "a few" to do the MRI. Says it won't change the course of action, and they're leary of going backwards by sedating him. (which they would have to do b/c he's still so confused)

Since he's still showing some med sensitivity and lots of confusion, they don't want to compound it, and hopefully in a day or two he'll be alert enough to be told "Hey Wee Jimmy, hold the frick still while we scan your bean!"

I get that. But g'dam, it's been a week now, and we're still in the dark as to what's wrong. Or right. Or where we're heading.

uuugh.