After looking after so many neuro cases we think nothing of it till a good friend's husb develop this horrible illness. He'll have a "lock-in" syndrome if he survived.
The mind is functioning but unable to verbalize nor move - thinks this is the worst situation in this world! If this happens to me, just disconnect me from the ventilator or don't treat me at all!That will be kinder.
Patients with a poor prognosis became comatose within 2 hours of onset, their pupils were dilated bilaterally, pin-point or anisocoric and the transverse diameter of the haematoma was over 20 mm.
These findings are similar to the findings from a series of 32 brainstem haemorrhages, except with respect to the size of the haematoma. The patients were divided into 3 groups on the basis of eventual outcome. Approximately 1/3 died within 1 month, 1/3 were severely disabled (most were alert, quadiplegic and communicated only with great difficulty) and 1/3 had only minimal neurological disability. Good prognosis was associated with alertness or only slight disturbance of consciousness, normal respiration, positive light reflex, normal heart rate and haematoma <2.5 cm.
