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How can I help my father recover from brain haemorrhage?

Q: My father met with an accident last year. He had a serious head injury. Doctors said that he had a blood clot in the head. Now after 10 months, he can't speak properly, his speech is slurred and he can't even write as his hands are shaky and he has no feeling of pain in the right side of the body. He has lost the sense of touch. He also suffered a fracture on the left leg. He can't walk by himself and someone has to hold him. His legs also ache while walking. He had suffered a heart attack a few months ago and was under medication.

A:The symptoms of patients with intra-cerebral bleeds vary depending on the area of the brain affected and the extent of the bleeding. In addition to the area of the brain injured by the haemorrhage, the surrounding brain can be damaged by pressure produced by the mass effect of the haematoma (blood clot). A general increase in intracranial pressure may occur. The prognosis varies depending on the severity of stroke and the location and the size of the haemorrhage. Many people recover completely after a stroke. For others, it can take many months to recover from a stroke. Of patients who survive stroke by more than 30 days, 10% demonstrate complete spontaneous recovery, 10% show no benefit from any treatment, and 80% may benefit from rehabilitative treatment. Physical therapy and other retraining methods greatly improve rehabilitation and recovery. Evidence from clinical trials suggests that early initiation of therapy influences the outcome favourably. When the initiation of therapy is delayed, patients may develop avoidable complications, such as contractures and de conditioning. Most recovery takes place in the first 3 months, and only minor additional measurable improvement occurs after 6 months following onset; however, recovery may continue over a longer period of time in some patients who have significant partial return of voluntary movement. A rehabilitation program includes - Physical therapy, Occupational therapy and Speech therapy. Rehabilitation should include therapy that is directed at specific training of skills and functional training. Physical therapy is given with sufficient intensity to promote skill acquisition and aims to increase range of motion, strengthen and mobilize muscles and enhance compensatory techniques. Occupational therapy aims to decrease the dependence of patients on others for performance of basic activities of daily living like bathing, dressing, feeding, toileting etc. Almost all patients show improved performance as recovery occurs and most improvement is noted in the first 6 months, although as many as 5% of patients show continued measurable improvement up to 12 months later.

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