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Aneurysm, Thalamic stroke: What can we do further for recovery?
My father was diagnosed with left P1 PCA and PCom junction aneurysm with mass effect over the pons and T2/FLAIR hyperintensity noted in pons, left middle cerebellar peduncle and superior cerebellum. The aneurysm measuring about 3.2(CC) * 2.4(TRA) * 2.7 (AP) cm.
Large dissecting P1 PCA aneurysm was treated with coil embolization by trapping from both left PCom and left P1 PCA.
Postoperatively, patient developed left PCA territory and P1 perforator infarcts (bilateral thalamic). Effective tracheostomy was done.
PEG was done for food intake. VP shunting was done for hydrocephalus.
After six months of coiling procedure, there is no distinct decrease in size of aneurysm and there has been odema according to latest MRI. He is maintaining oxygen saturation in room air. Moving of right upper and lower limb on painful stimuli. Sometimes, left limbs too. There is ever lasting dilatation of left pupil. The position of right hand of body is that of medial rotation with stiffness in both lower and upper right limb. There is irregular sweating from the right side of the body. He himself is an orthopaedic surgeon. What can we do further for his treatment? Any help, suggestions? Can we bring back his tone with physiotherapy ?
I believe in miracles.
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My husband had thalamus strokes in. April 2021...three. He has a serious sensory issue. The electrical shock feeling that you describe along right side of his body. It has been frustrating because so few know or understand what you guys experience! That includes the clinicians! We tried an off label treatment that held great promise for a day but the symptoms quickly returned. His only relief is getting into a pool of water. Oddly, the electrical feeling totally goes away. He exercises in the pool to keep muscle tone on right side. Fortunately, he does not have the headaches! I sure pray there is someone or something that can be found to help help you and all the others dealing with these difficult issues from Thalamic stroke. He has tried a few meds but not really noticing any improvement. Maybe sleeping a lil better with the Gabapentin but no help with sensory issues. There has to be something!! Please share if you have found anything that helps you? Was your vision affected? His was... he has a small blind spot from right out of both eyes. Hence, I do more of his texting etc.
He also talks about PAIN that seems an awful like it is from the Thalamic damage. If it is, it’s a big deal and should be treated by a knowledgeable neurologist.
I’m new at using this Mayo Clinic site. His is my second reply. To pickleballnut, your husband is lucky to have you. I had my stroke in 2006 with no motor damage but I did come away with “post-stroke central pain” or sometimes the old “Thalamic pain” if you’re looking it up. So far Lyrica (pregabalin):is what does me the most good. Savella keeps my fingers and feet from feeling like they’re on fire at night. Lamotrigne seems to have helped with the rest, though a lot of it remains, but I can think about other things now but the pain. Also. Gabapentin may need to be prescribed in HUGE doses to help his pain. I asked to be put on Lyrica instead. I also asked to be prescribed lamotrigne. For his kind of pain you need to be proactive. My meds may not work for you. I just wanted to tell you that you are probably alone. Sorry. It doesn’t go away. Keep pushing. My best to both of you.
Welcome @bestofthebest. Great tips for dealing with post-stroke pain. How are you doing today?