Doctor wants to take away life support, but is there a chance for my relative to recover from her brain hemorrhage?

[uuuccc]

Hello! My close relative got taken into the neurological intensive care unit after I and my family members immediately noticed her hemorrhagic stroke symptoms. The stroke was in the Thalamus. For 12 days she slowly improved. Her pupils started to react to light, her arm stretched due to pain stimuli, and later on she even retracted the arm away from the pain. Things turned for the worse when she got pulmonary embolism and a build up of mucus in the lower part of the lung. The breathing temporarily got worse but later improved after these problems were addressed with medication and suction of mucus.

However, after this ordeal the breathing rhythm is fast and slightly weak. Plus, the level of consciousness is decreased. Very abruptly the doctor told us that she will not survive this due to (seemingly unrelated) brain stem injury that had never been mentioned up until right now. MR-scans from one week ago show some blood from the bleeding adjacent to but not covering the upper brain stem. This and loss of some reflexes and irregular breathing makes the doctor fully sure that there is no point putting her back in a respirator if it was ever needed.

This makes me think of the ABCDE standard for determining a patient's state. It states we should check and optimize airways (A), breathing (B), and circulation (C) before stating that the symptoms are merely due to neurological factors (D) as far as I understand it. Perhaps I'm wrong, please correct me if so.

The main point we have is that her mental state was improving up until the ordeal with the lungs. What if these breathing problems not having been fully dealt with may affect the degree of consciousness and even reflexes? Is this possible? Of course it's also possible the brain was damaged due to lack of oxygen during the time when the lungs weren't at full capacity. Obviously we're grabbing every possible alternative here. Every possible reason for the decreased consciousness must be looked at is what we feel. The doctor also insinuated that the brain stem damage is irreversible. Is there a way to be 100% sure about that?

We'll try to get a second opinion, but if anyone has any insight here it might save a life, and would be greatly appreciated.

I wrote this very tired so if there is anything that should be clarify please say.

[Sepsur]

I hope you get more positive news over the next few days.

[Rhyl1 Partner Moderator ICUsteps]

It is possible to recover from a brain stem injury but unfortunately it’s a small minority of patients. It depends on the degree of injury and that is difficult to comment on that for your relative. I would advise a second opinion to reassure you that everything is being done that can be done.

[uuuccc in reply to Rhyl1]

Thank you very much for your reply. We will definitely get a second opinion. The immense risk of a bad outcome is clear with us, but it just feels wrong to not do everything for my relative.