Brain bleed or metastasized lung cancer?

Posted by gakimble @gakimble, Dec 22, 2018

I am a 42 year old daughter. I am also an occupational therapist with experience in neuro rehab. 1 month ago my father had a lobectomy, removing the top and middle lobes of his right lung due to dx of non small cell carcinoma. Afterwards, he went into a-fib. He was discharged home after 4 days. He had terrible hiccups (he swears this was the beginning of it all) and needed help with ambulation. (My dad is 64 and was super active before the surgery). As the week progressed we noticed slurred speech. The pulmonologist, noticing the speech and gait, prescribed blood thinner thinking my dad had a clot, but he did not run any tests. Few more days then vomiting, then headache. We went to the ER then ICU with dx of large bleed in the occipital lobe. He stayed for 12 days, discharged home and 4 days later was back at ER with more vomiting and headache. New CT scan revealed 9 new lesions spread throughout the brain. Radiologist and Neurologist have told us that the lung cancer has spread, even suggesting the cancer may have started in the brain. The neurosurgeon and oncologist feel strongly that these are bleeds and should be treated as a stroke. I want to take him to Mayo Clinic. My step mom wants to keep him here and try for rehab. I just want to completely rule out cancer. I saw the MRI with the neurologist, but I dont know what a bleed vs met would look like. Ive tried looking online but dont think this is the best practice. Now it is the Christmas season and my dad is in the ICU with a skeleton crew, little therapy, and waiting for the doctors to come back from vacation. I am scared and frustrated. Please advise… (also those hiccups are still there???) Thank you so much in advance for any help.

Hello @gakimble,

Welcome to Connect. If your father’s doctors feel his symptoms indicate a stroke, then prompt treatment is crucial. If you would like to make an appointment at Mayo Clinic please call one of our appointment offices; you can also request an appointment online. The contact information for Minnesota, Arizona and Florida can be found here: http://www.mayoclinic.org/appointments
Mayo Clinic's world-renowned stroke teams include doctors trained in blood vessel and brain conditions (cerebrovascular neurologists), brain blood vessel imaging (endovascular surgical neuroradiologists), blood vessel brain surgery (vascular neurosurgeons), physical medicine and rehabilitation (physiatrists), emergency medicine, and other subspecialists who work together to provide exactly the care you need.

Here are some other Mayo Connect discussions about strokes and brain bleeds that you might find helpful,
https://connect.mayoclinic.org/discussion/brain-bleed/ and
https://connect.mayoclinic.org/discussion/cerebellar-stroke-experiencetreatmentrecovery/

I’m bringing fellow members @marymar @lsatenst1 @soloact @lakelifelady @strokesurvivordynamo @ebkramer @ej0114 @fekind @tazi0 and @beachgal8 into this discussion about strokes and rehab after stroke to share their experiences.

Could you tell us more about the hiccups your dad is experiencing? How often do they occur? Are there any triggers that set them off?

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Thank you for the links. I will share. The hiccups started shortly after the lobectomy. They are very strong and he makes a gasping/ high pitched noise that lasts longer than a normal hiccup would. Most but not all are followed by a large burp. He has had terrible acid reflux also so sometimes after the hiccup, acid will come up and he has to spit it out. They gave him thorazine which helped but made him too groggy. They are giving him something that starts with a 'phent'… he will get a 20 or 30 min relief then they start up again for hours. No triggers that we have noticed yet

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