Does this really represent no brain activity after a stroke?

A fellow caregiver asked...

My brother suffered an aneurysm and a stroke. The doctors stated he is lucky to be alive. This happened 11/10/09 and the doctors have stated that his 'CT' indicates no real brain activity. But when you ask my brother a question he can respond by shaking his head yes or no. He also responds on command if you ask him to squeeze your hand. The doctors stated they don't know what this is. My question: is this a sign my brother will be ok?

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

Let me first start by saying that as a stroke physician, I typically do not see patients with ruptured aneurysms - they are more commonly followed by Neurosurgeons - so please take this answer with "a grain of salt", so to speak.

In general, if your brother is truly following your instructions and answering questions, that is a good sign that you can expect further recovery over the next few months. I would not say he will "be ok", because I am not sure what would be "ok" for him. He may recover somewhat, but still need a feeding tube and assistance with his daily activities. For some, that would be "ok", as long as they are alive and able to interact with their family. For others, that would not be acceptable.

In general, a good way to predict his outcome is simply to graph out on a piece of paper his progress thus far, and continue that trend for another 3-4 months. That is likely where he will end up.

Finally, a CT would not show brain activity, rather, it would only show the brain itself. An EEG (electroencephalogram) might be a bit better for looking at brain activity and helping prognostication of his eventual outcome.