Randy Travis Has a Stroke/ Second Emergency Surgery

For country music icon Randy Travis, things have gone from bad to worse.

Not only did he need emergency surgery to stabilize his failing heart from viral cardiomyopathy- last night Travis suffered a stroke and had a surgical procedure to relieve pressure on his brain.

In a statement from his representative, Kirt Webster

As a complication of his congestive heart failure, Mr. Randy Travis has suffered a stroke and is currently undergoing surgery to relieve pressure on his brain.

Travis remains in critical condition.

There are two kinds of stroke:

Hemorrhagic Stroke: When an artery in the brain bursts, blood spews out into the surrounding tissue and upsets not only the blood supply but the delicate chemical balance neurons require to function. This is called a hemorrhagic stroke. Such strokes account for approximately 20 percent of all strokes.

Ischemic Stroke: The most common kind is caused by a blood clot or the narrowing of a blood vessel (artery) leading to the brain. This keeps blood from flowing into other parts of the brain and keeps needed oxygen and nutrients from reaching brain cells there.

Either type of stroke can cause swelling in the affected area of the brain -just like when it swells when you injure your knee. Unfortunately, the major difference between these two types of injuries is that the brain resides inside a bony skull. Swelling of the brain in this enclosed space leads to an increase in the pressure in the brain, called intracranial pressure.

This increase in intracranial pressure decreases blood flow to the brain and can damage previously unaffected brain tissue. If the pressure raises high enough, it can cause the brain tissue to be squeezed across structures (such as bony openings) within the skull, called brain herniation. Brain herniation is a medical emergency that can lead to death or severe disability.

To prevent herniation, physicians may remove a part of the skull to relieve intracranial pressure. This procedure is called decompressive craniectomy. In this procedure, a section of the skull is surgically removed. The removed piece of bone may be frozen or can be preserved in a pocket under the skin of the patient’s abdomen. This piece of bone is reattached to the skull when the patient has sufficiently recovered.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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