Hemorrhagic stroke occurs when a weakened blood vessel ruptures and spills blood into the surrounding portions of the brain. Risk factors for strokes may include diet, cigarette smoking, elevated LDL cholesterol, and blood pressure, among uncontrollable variables including race, gender, and age. While strokes are common, with 795,000 Americans suffering a new or recurrent stroke each year, hemorrhagic strokes are rarer than their counterpart, the ischemic stroke, composing only 13% of reported strokes. Outcomes after a stroke vary and depend greatly on the type and location of the stroke as well as the timing of the identification, response, and treatment.
Our patient, Mr. John Doe, was found unresponsive on a roadside and brought to the OSH, where he presented with active vomiting and flexor posturing. After a CT scan was performed, he was found to have had a right basal nuclei & thalamic intraparenchymal hemorrhage with intraventricular hemorrhage extending into the lateral ventricles and 4th ventricle. He was soon admitted to UW, intubated and sedated, for further management. Upon admission, he was noted to be homeless, with no family to contact immediately and no past medical history available. On day 2 of his UW admission, a feeding tube was placed and on day 3, enteral nutrition (EN) was initiated. This case study aims to explore the role of nutrition support throughout Mr. Doe’s complex hospital course, addressing EN in the setting of intubation with sedation, neurologic deficit, continuous renal replacement therapy, and eventually palliative care.
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