What to do if a stroke patient is unconscious and unresponsive
Sep 13, 2022
Source: Cainiu Health
Dr. Yang Jun
Introduction
For unconscious patients with cerebral infarction, consider relatively large infarct areas or lesions affecting the ascending reticular activating system, such as brainstem involvement. For cerebral infarction occurring within four and a half hours of symptom onset, intravenous thrombolysis may be considered. If the patient has a relatively large infarct area, rescue treatments such as intra-arterial thrombolysis or mechanical thrombectomy may also be considered.
As China enters an aging society, an increasing number of people are suffering from cerebral infarction. Many individuals with cerebral infarction experience sequelae such as memory decline, slowed reactions, slurred speech, and impaired mobility, which significantly affect their quality of life. So what should be done when a patient falls into a coma due to cerebral infarction?
What to do when a patient is unconscious due to cerebral infarction
For patients with cerebral infarction who have lost consciousness, it is likely that the infarct involves a relatively large area or affects critical regions such as the ascending reticular activating system—commonly seen in brainstem lesions. For acute cerebral infarction, if treatment is initiated within 4.5 hours of symptom onset, intravenous thrombolysis may be considered. If the infarct area is relatively large, endovascular treatments such as intra-arterial thrombolysis or mechanical thrombectomy can also be considered for emergency intervention. After the acute phase, anticoagulant therapy, antiplatelet therapy, or defibrillation may be used as symptomatic treatments depending on the patient's condition. Vital signs must be closely monitored. When necessary, a nasogastric tube should be placed and suctioning performed regularly to prevent aspiration pneumonia and secondary infections that could worsen the cerebral infarction.
Loss of consciousness in patients with cerebral infarction is typically attributed to brainstem infarction or extensive cerebral infarction, indicating severe damage to brain cells. Currently, drug therapy remains the primary approach for patients in coma due to cerebral infarction. Medications such as mannitol or glycerol fructose may be administered to reduce intracranial pressure and alleviate local cerebral edema. Additionally, drugs that improve microcirculation—such as Xuesaitong (Panax notoginseng saponins), Shuxuetong, or Shuxuening—may be given via intravenous infusion. It is also essential to actively prevent complications such as urinary tract infections and pulmonary infections.
Patients are advised to maintain healthy lifestyle habits, follow a light diet, and keep a positive mood. We hope this information is helpful. Wishing you good health and happiness.
