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Brainstem hemorrhage
How to rehabilitate from brainstem hemorrhage?
For patients with brainstem hemorrhage, it is often recommended during the acute phase to treat them with medications for hemostasis, brain enhancement, nerve nutrition, dehydration to reduce intracranial pressure, and inhibition of gastric acid. It is also important to actively treat complications and comorbidities caused by the brainstem hemorrhage. For these patients, when the condition is stable, appropriate rehabilitation exercises should be carried out. For patients with hemiplegia or aphasia, rehabilitation exercises can be done on the affected limbs, and speech rehabilitation training can help improve current conditions of hemiplegia and aphasia. Additionally, for these patients, active and passive massage of the limbs should be initiated early to prevent muscle atrophy and joint stiffness.
Symptoms of brainstem hemorrhage
The symptoms of brainstem hemorrhage can vary from mild to severe, depending on the specific presentation of the patient. For instance, in milder cases, symptoms may include simple headaches, dizziness, nausea, and vomiting without other clinical symptoms, which can often be easily distinguished from cervical spondylosis. Therefore, timely clinical examinations are necessary to confirm these conditions, which are generally mild and usually do not threaten life. However, symptoms might gradually worsen, manifesting as numbness in the limbs and speech impairments, among others. Some individuals may experience seizures, characterized by convulsions of the limbs, frothing at the mouth, etc. If the hemorrhage becomes more severe, it can compress more brainstem neurons, leading to coma, lethargy, and potentially severe outcomes like dilated pupils, and sudden cessation of breathing and circulation.
How long does it take for a brainstem hemorrhage clot to be absorbed?
In general, the absorption time for a brainstem hemorrhage clot is around two to three weeks. During this period, several phases must be passed, with the two main ones being the rebleeding phase and the brain swelling phase. Rebleeding often occurs within three days after the initial bleeding. If not treated promptly during this time, it can easily lead to further brainstem hemorrhage, increasing the size of the clot and hindering the later absorption process. The second phase is the peak of brain swelling and vasospasm. During this phase, certain substances released during the absorption of blood vessels and clots can cause swelling and spasms of the surrounding tissues. If this phase is also safely navigated, then subsequent absorption tends to be relatively quicker. However, complete absorption generally requires at least two to three weeks.
Is brainstem hemorrhage prone to recurrence?
Brainstem hemorrhage is perilous, and its recurrence largely depends on the cause and the management of risk factors. For instance, one significant cause of brainstem hemorrhage is the presence of certain arterial-venous malformations and sponge-like angiomas. Such conditions tend to recur if not surgically addressed promptly by removing these abnormal vessels, thereby reducing the likelihood of recurrence. Additionally, hypertension is the most common cause of brainstem hemorrhage. Long-term high blood pressure can damage arterial walls and lead to ruptures and bleeding. Stable control of blood pressure, alongside a low-salt, low-fat diet, can prevent recurrence of brainstem hemorrhage. However, poorly controlled blood pressure, resulting in severe fluctuations, can significantly increase the risk of recurrence.
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.