### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
a friend of mine had stroke on his right side of the brain and for the past 5 days. Before the stroke, he had fever almost every night after 8PM almost for 7 days. He is now in hospital and has his right hand weakness and TOTALLY SPEECHLESS. When spoke with Doctor, he said that they are taking ct-scan to check if the bleeding is progressing - I don t know what he meant this - is that something that it could get worse... Again, please could you let me know if he would be able to gain back his speech and how long this could take? It may be noted that he is going to toilet alone with the support of the nurse and closes the door behind and opens by himself! Also, I may note that he is 46 years and is diabetes ... Thanks,

### output:

Hello, Im very sorry to hear about your friends stroke. Here is some information relation to hemorrhagic strokes (brain bleeds).First, brain bleeds can happen for different reasons such as a head injury (traumatic), a rupture of an aneurysm and bleed within the brain matter itself (parenchymal hemorrhage). It is very important in your friends' case to determine what caused his bleed. Given his fevers any infections need to be ruled out and an echocardiogram (ultrasound of the heart) should be done to rule out any sort of infection of the heart valves which could send bacteria to the brain which could result in a bleed. He absolutely needs to have blood vessel imaging in the form of either a CT angiogram and MR angiogram to make sure that there are no abnormal collections of blood vessels in the brain and aneurysms that could have cause the bleed. Also, when there is a bleed in the brain a tumor must also be ruled out. All that being said, the most common cause of a bleed in the brain is due to high blood pressure which causes weakening of blood vessels and can result in a hemorrhage. Most commonly management of brain hemorrhages is supportive, meaning that the only things that are done is blood pressure control, pain management and if the person is unconscious then support for breathing. If the bleed is very large then surgical intervention may be necessary. What the doctors are saying as that they want to repeat a CT scan to see if the bleed has become larger, which can sometimes happen. There are several risk factors for the bleed worsening: one is poor blood pressure control, another is if there is an underlying aneurysm or blood vessel that could bleed. That's why it is so important to determine what caused the bleed. For small bleeds with no underlying vascular or malignant pathology the outcome is typically fairly good. The blood causes irritation and pressure on the surrounding brain causing weakness and neurological symptoms, but as the blood subsides the symptoms improve and sometimes there may be a remarkable improvement. The language area of the brain is very delicate, and it is hard to predict how well he will recover, but my best educated guess is that he will recover at least some language function and could even recover close to how he was though probably never quite back to level his language was before the bleed. It sounds like he is doing relatively well overall since he is able to go to the restroom without support, so that is an encouraging sign. Hope I have answered your query. Let me know if I can assist you further. 