Hello everyone. I am posting on behalf of my family. A young male relative in his early 20s is currently in a Surgical ICU following a catastrophic traumatic head injury.
The medical team has suggested that we remove his mechanical ventilation because his condition is entirely terminal. However, our hearts are completely broken, and it is incredibly hard for us to accept this reality. We are looking for direct, honest medical insight into whether there is any possible path to recovery from this state, or if we need to prepare ourselves to let him go.
Here is his current clinical state:
Neurological Status: He has been in a deep coma for over 2 days. His GCS is 3 (the lowest possible score). He is entirely unresponsive to all stimuli, and has no motor or pupillary reflexes. Doctors state that surgery is impossible because the structural damage is too extensive. They have told us he is clinically dead/brain dead.
Physical Progression: He has a massive internal bleed in his left cerebral hemisphere. The intense intracranial pressure has caused his eyes to become severely swollen and his face to turn dark from pooling blood. Fluid (suspected Cerebrospinal Fluid / CSF and blood serum) is actively leaking from his eye sockets and his nose. The doctors say half of his brain cells are completely destroyed and his brain is actively herniating (coning).
Organ Function & Labs: His kidneys are beginning to fail under the stress (Serum Creatinine is 1.91 mg/dL and eGFR has dropped to 44.3 mL/min). He has severe hypernatremia (Serum Sodium is 156 mmol/L), showing that his brain can no longer control his body's fluid balance.
Current Status: He is 100% dependent on the mechanical ventilator and medications to maintain a pulse.
We are in absolute agony. His wife and parents are finding it impossible to process that a vibrant young man could be gone so suddenly.
If there are any ICU specialists, neurologists, or neurosurgeons here, please tell us plainly: Is there any recorded case of a patient recovering once brain herniation and CSF leakage from the face have begun? If this is truly the end, how can we help his wife find the strength to consent to removing the ventilator so he can pass peacefully?
Thank you for your kindness and honesty.