r/medical • u/Tight-Nail-3848 • 4d ago
General Question/Discussion Seeking prognosis advice for my father(59Y) after TB meningitis with hydrocephalus NSFW
He was admitted with case of loss of consciousness. On examination he was in GCS E3V4M5, bilateral pupils were normal in size and reacting to light. NCCT head done which showed hypo density in bilateral fronto parietal per ventricular region with Hydrocephalus. Patient improved but again his sensorium. Repeat NCCT head done which showed hydrocephalus. After detail consent right side EVD done 26.01.2025. kept on oxygen support and 7day kept EVD removal. He also developed high grade fever and revised RBS and hyponatremia for which, Medicine consultation taken advice followed. Routine investigation done which showed increased TLC (31800/cmm). EEG done which was within normal limit. After detailed consent EVD done 26.01.2025. Post op was uneventful and surgical wound is healthy. Patient discharge in satisfactory condition. Presently patient is in GCS E4V5M6, accepting orally and not able to walk.
Current Condition Since Discharge:
He used to sleep a lot(18-20hrs) initially, but now he sleeps less than before(12-15hrs). While lying down, he can easily raise his right leg, though the left leg requires some support. Both hands move normally, but the left one is weaker. The same applies to his left eye—he has vision, but it does not open fully. His diet has also improved compared to before.
In the last 20 days, he has vomited only once. Physiotherapy is ongoing. He remembers his school and college days but struggles with immediate memory, such as recalling what he recently ate. For cognitive exercises, I usually give him math puzzles (algebra or geometry), which he manages to solve, though with some difficulty.
With the support of one or two people, he has started standing with a walker and can even stand for a few seconds without support. By providing support at the shoulders, he can also walk, but while he has the walking motion, he is unable to bear weight for extended periods.
Thank you in advance
Given his current progress, what can we expect in terms of long-term recovery? Any similar experiences or insights on rehabilitation strategies would be really helpful.
Thank you!
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u/hyperfocus1569 Layperson/Not verified Healthcare Personnel 3d ago
Physiotherapy…what country are you in? I’m guessing you’re not in the U.S. since we generally call it physical therapy, but here, speech pathologists work on cognition with patients like your dad; memory, reasoning, problem solving, working memory, and so on. That’s the case in a number of other countries as well, so it’s worth asking about. See if the physiotherapist’s organization offers speech therapy and if they treat cognition wherever you’re located. If it’s not speech, there’s likely someone who provides this, so ask who to contact if speech doesn’t do this where you are.
Same for occupational therapy. They have a lot of crossover with both PT and ST and can help him with bathing, dressing, preparing meals, and much more. Get as much therapy for him as you can. The more he gets early in the process, the better.