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Brainstem hemorrhage
Dietary Precautions for Brainstem Hemorrhage
For patients with brainstem hemorrhage, attention should be given to their diet. During the acute phase, it is advisable to choose a liquid diet, as most patients with brainstem hemorrhage often have severe swallowing dysfunction. Failing to choose a liquid diet can lead to aspiration, which in turn causes aspiration pneumonia. Furthermore, patients should avoid certain foods for a short period, particularly greasy or spicy foods, as most patients experience significant reductions in digestive function during the acute phase. If dietary intake is not carefully managed, patients often experience significant abdominal pain and diarrhea. Once the patient's condition stabilizes, it is appropriate to include fresh vegetables and fruits in their diet.
How many milliliters of brainstem hemorrhage are fatal?
Brainstem hemorrhage does not have a specific volume that can be fatal; the brainstem is the central hub for respiration and circulation in the human body, including the medulla, midbrain, and pons. For the pons and midbrain, a hemorrhage of five milliliters can be fatal. For the medulla, which is very narrow and densely packed with neural tissue, even one milliliter of bleeding can suddenly cause the patient's respiration and circulation to stop. Therefore, even one milliliter of brainstem hemorrhage is an immeasurable loss, and brainstem hemorrhages should be classified as critically severe. Immediate hospitalization and treatment are crucial to achieve a relatively better prognosis.
Why does gastric bleeding also occur when there is bleeding in the brainstem?
This brainstem hemorrhage, as well as other severe cranial traumas or cerebral hemorrhages, if they cause a severe intracranial hypertension, will lead to a condition called stress ulcer, commonly known as Cushing's ulcer. This occurs because the increased intracranial pressure causes ischemia and hypoxia in the gastric mucosa, which then leads to localized, extensive necrosis of the gastric mucosa, resulting in upper gastrointestinal bleeding. This includes brainstem hemorrhages and many other cranial injuries and cerebral hemorrhages with intracranial hypertension as a very common complication. Therefore, it is due to the local ischemia of the gastric mucosa caused by increased intracranial pressure, leading to bleeding caused by gastric acid corrosion.
How to administer first aid for brainstem hemorrhage
For patients with brainstem hemorrhage, once signs of brainstem hemorrhage are detected, the patient should be sent to the local hospital immediately for an emergency head CT scan to help determine the location and severity of the hemorrhage. Due to its special location, brainstem hemorrhage is often difficult to treat surgically in most cases. Once brainstem hemorrhage occurs, the patient should first be transferred to the intensive care unit for close monitoring of vital signs. At the same time, administer medications to stop bleeding, enhance brain function, nourish nerves, promote dehydration, and reduce intracranial pressure, while carefully observing changes in the patient's condition. During treatment, strictly prevent and treat various comorbidities or complications. (Please use medications under the guidance of a professional physician and do not self-medicate.)
Brainstem hemorrhage is what?
There are many causes of brainstem hemorrhage, and clinically, it is mostly considered to be caused by hypertensive cerebral hemorrhage. Patients have a history of hypertension and have not received regular and effective antihypertensive treatment, leading to suboptimal blood pressure control. Excessively high blood pressure often results in the weakening or even disappearance of the patient's own vascular regulatory functions. Under certain triggering factors, such as fatigue, exhaustion, mental stress, or overly intense emotions, the blood pressure within the vessels may exceed their own regulatory capabilities, making bleeding more likely. If the bleeding occurs in the brainstem, it manifests as a brainstem hemorrhage. In some patients, brainstem hemorrhages are caused by conditions like cavernous angiomas, aneurysms, or arteriovenous malformations.
What causes fever from brainstem hemorrhage?
Patients with brainstem hemorrhage experience fever generally for the following three reasons: First, infection. Patients with brainstem hemorrhage often have disturbances of consciousness and dysfunction of the throat, and are bedridden, which frequently leads to aspiration pneumonia and hypostatic pneumonia. This is due to weakened ability to clear phlegm, as well as choking caused by saliva and feeding. Additionally, infections can easily occur in the gastrointestinal tract, urinary tract, and from skin pressure sores. Second, abnormalities in the temperature set point cause central hyperthermia. In patients with brainstem hemorrhage, the temperature regulation center is damaged. If the temperature regulating center sets the body temperature above 38 degrees Celsius, it often persists and cannot be reduced, and medications are poorly effective in lowering the temperature, necessitating the use of ice packs for physical cooling. Third, patients with brainstem hemorrhage often use large doses of diuretics. Dehydration after diuretic use can put patients in a state of excessive dehydration. If rehydration therapy is not adequately managed, dehydration fever can easily occur.
How long does it take for the fever to subside after a brainstem hemorrhage?
For patients with brainstem hemorrhage, it is common to develop high fever after the bleeding, where the body temperature often exceeds 38.5℃. There are many reasons for the occurrence of high fever. It can be considered that the presence of an intracerebral hematoma compresses the hypothalamic temperature set point, causing abnormalities in the set point function and leading to central fever, with temperatures often reaching 39℃ or even higher than 40℃. At this time, the use of antipyretic drugs alone generally has poor therapeutic effect. It often requires the effective absorption of the intracerebral hematoma for the body temperature to gradually return to normal. Another situation, considering the occurrence of pulmonary infection, it is necessary to promptly provide patients with antibiotics for effective treatment. When the pulmonary infection is effectively controlled, the body temperature will also gradually decrease.
Can I drink fish soup with brainstem hemorrhage?
The patient experienced a brainstem hemorrhage, and if the bleeding is extensive, it's possible that the patient could be in a deep coma. In more severe cases, brain death could occur, where the patient would not be able to breathe on their own. Since the pathology mainly occurs in the brain, when the patient is in a coma, they are certainly not able to eat by themselves. At this time, feeding usually involves the insertion of a tube through the nose down to the stomach, called a nasogastric tube. Through this tube, food is delivered directly to the stomach, allowing for gastrointestinal nutrition. Commonly, the gastrointestinal function of such patients remains normal, so it is possible to administer liquid nutrition through the nasogastric tube, such as nutrient solutions or fish soup, without any issues.
How to rehabilitate through exercise after brainstem hemorrhage
Regarding the specific measures for rehabilitation exercises for brainstem hemorrhage, it is necessary to analyze specific problems based on the different conditions of the patients. Based on our past experience, several common symptoms of brainstem hemorrhage can be addressed with corresponding rehabilitation measures. The first one is swallowing disorder, which is very common in patients with brainstem hemorrhage. We can provide patients with electrical stimulation and ice stimulation, and teach them morning exercises such as cheek puffing, tongue stretching, and dry swallowing practices. The second common issue is articulation disorder, for which we can teach patients some speech training. Usually, we can prepare patients with rhythm, cadence, and deep breathing exercises for speech training. The third is the dysfunction of limb mobility. For specific activities, we need to conduct training, including some balance function training.
How does a brainstem hemorrhage clot get absorbed?
For patients with brainstem hemorrhage, edema generally enters the edema phase within 24 to 48 hours, and then gradually transitions into the absorption phase. During this period, it is first necessary to provide the patient with medications that enhance brain function, promote blood circulation and remove blood stasis, and nourish the nerves for treatment. At the same time, it is important to monitor changes in the patient's condition, and regularly perform a head CT scan to dynamically observe the changes in cerebral hematoma. In most cases, it is necessary to prevent various complications or concurrent diseases. If there is an abnormality in coagulation function, it is advisable to administer hemostatic drugs for treatment during the acute phase. However, once the patient's condition stabilizes, use medications that improve cerebral microcirculation and promote blood circulation and remove blood stasis for treatment.