Clinical course of a tracheostomized patient with a hemorrhagic pontomedullary stroke
A case report
Abstract
Introduction: There is scarce published scientific evidence about the rehabilitation and clinical course of subjects who have suffered a brainstem stroke and required a tracheostomy. The objective of this study is to describe the clinical course of a tracheostomized patient with a hemorrhagic pontomedullary stroke.
Case presentation: A 58-year-old male was admitted to Hospital Pedro Fiorito on November 21, 2017. The patient experienced sensory deterioration, required orotracheal intubation and mechanical ventilatory assistance, and was assigned to early tracheostomy. After being transferred to the inpatient ward, he underwent orofacial rehabilitation and, simultaneously, received laryngeal and pharyngeal stimulation with compressed air through the subglottic port. Cuff deflation tolerance and cannula occlusion with a cap were tested one week later. Due to the favorable test results and absence of infectious intercurrences, decannulation was decided. Regarding his motor and functional characteristics, the Barthel index scores obtained were 15, 45, and 85, at baseline assessment, hospital discharge, and 6-month follow-up, respectively.
Conclusion: The patient progressed favorably. He attained oral feeding, was decannulated, and became independent in his activities of daily living.
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