The brain stroke that felled Pravin Mahajan is described as extensive pontine haemorrhage, which means a bleed in the tiny part of the brain stem that is called pons.
Dr Sangeeta Rawat of KEM Hospital's neurology department told Times of India: "This is a region that is very dense with neurons but extremely small in area". A stroke in this small area would be more critical than, say, a stroke in the cerebrum which is spread over a larger area.
Brain attacks or strokes can be caused by two reasons—an infarct or sudden stoppage of blood supply to a region, or haemorrhage. Between the two, haemorrhages are considered more critical.
“Among haemorrhages in various parts of the brain, a pontine haemorrhage is the worst to have,'' said Dr Alok Sharma, head of neurosurgery at Sion Hospital. “It is the most grievous of all haemorrhages,'' he said.
Moreover, as the seat of breathing, swallowing, seeing, among other vital functions, any damage in this area spells bad news. The recovery, added Dr Sharma, depended on the degree of stroke. “If it is a small bleed, there can be better recovery,'' he said.
But a senior neurologist pointed out that most pontine haemorrhages leave behind some degree of disability. “The damage is usually so extensive that rarely do patients, even in the best centres of the world, pull through 48 hours,'' said the doctor. If the patient manages to pull through this window period, then an assessment of the damage can reveal the extent to which the patient's brain functions have been affected.
In Mahajan's case, doctors have said that the next 72 hours are critical. On Saturday, the Jupiter Hospital team of doctors said that surgery would be of no use for Mahajan.
“We are only managing the patient with medicines,'' they said. Stating that the family didn't want to talk to reporters, the doctors said that the condition has 70% to 80% non-survival chances.
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