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Brainstem hemorrhage
Is brainstem hemorrhage related to smoking?
Brainstem hemorrhage is somewhat related to smoking. For brainstem hemorrhage, smoking acts as a trigger. During the process of smoking, the nicotine in tobacco may cause constriction of the brain's blood vessels, leading to increased blood pressure. When blood pressure rises beyond the blood vessels' ability to regulate themselves, it often induces the vessels to rupture and bleed, resulting in a brainstem hemorrhage. Of course, for brainstem hemorrhage, smoking is just one triggering factor and not the sole cause. For these patients, the majority of cases are largely related to poor lifestyle habits, poor dietary habits, and the individual's underlying vascular conditions.
Is it right to give up treatment for brainstem hemorrhage?
Brainstem hemorrhage discontinuing treatment could be appropriate in some cases. If the patient has extensive brainstem hemorrhage, particularly at the lower end of the brainstem, and has resulted in deep coma without response to any stimuli, with a Glasgow Coma Scale score of only 3, dilated pupils on both sides without any pupillary light reflex, and possibly no spontaneous breathing, the patient could be considered brain dead. According to international practice, treatment should not be pursued for patients who are brain dead, hence discontinuing treatment is appropriate for such patients. If the patient still has spontaneous breathing, then active resuscitation should be pursued, otherwise, it might be considered inhumane.
Does brainstem hemorrhage easily recur?
The main cause of brainstem hemorrhage is hypertension, which can lead to hyalinization in the arteries that supply the brainstem, and even the formation of small aneurysms. Under the impact of blood flow, these are prone to rupture, leading to hemorrhage in the brainstem. This is the primary mechanism of onset for brainstem hemorrhage. If the brainstem hemorrhage is caused by hypertension, maintaining good control of blood pressure and keeping it below the ideal level of 140-90 mmHg can prevent frequent recurrence, so there is no need for excessive worry, but it is crucial to monitor blood pressure regularly. Additionally, brainstem hemorrhages can also be caused by other reasons, such as cavernous hemangiomas or arteriovenous malformations. If brainstem hemorrhage is caused by these diseases, and the abnormal vessels are not surgically removed, recurrence is likely. Removing these abnormal vessels can greatly reduce the likelihood of recurrent brainstem hemorrhages.
What will happen after waking up from a brainstem hemorrhage?
For patients suffering from brainstem hemorrhage, when they are conscious, they often exhibit symptoms of neurological dysfunction. For instance, many patients may experience mild cognitive impairments, such as a decline in memory, as well as a noticeable decrease in learning and calculation abilities. Some patients might lose language functions or display significant aphasia, including anomia, motor aphasia, or mixed aphasia. Additionally, some patients may concurrently suffer from dysphagia, characterized by frequent coughing episodes when drinking fluids. Furthermore, some patients may exhibit specific symptoms or signs of limb motor dysfunction. Such patients typically require ongoing effective treatment.
How is brainstem hemorrhage caused?
There are many causes of brainstem hemorrhage, and in most clinical cases, it is seen in patients who have a history of hypertension and diabetes, and whose blood pressure and blood sugar have not been well controlled. Over time, due to prolonged high blood pressure or high blood sugar, arteriosclerotic changes occur in the vessels, and the vessels' own contractile function gradually declines. Under certain triggering factors, such as fatigue, exhaustion, mental stress, or excessive emotional excitement, the patient may experience transient dilation of the vessels, exceeding their regulatory capacity, which can lead to brainstem hemorrhage. Once brainstem hemorrhage occurs, it often leads to significant disturbances in consciousness within a short period, manifested as stupor or coma.
What will happen with brainstem hemorrhage?
Brainstem hemorrhage is a very dangerous disease because the structure of the brainstem is so crucial. It contains the life centers responsible for breathing and heartbeat, as well as sensory and motor nerve fibers passing through it. If the brainstem hemorrhage is severe and the amount of bleeding is large, the patient may experience paralysis of the limbs, swallowing dysfunction, and choking on water, among other symptoms. If the condition worsens, it can lead to coma, persistent high fever, and even death. Patients with minor brainstem hemorrhages may exhibit symptoms such as dizziness, nausea, vomiting, numbness in the limbs, and paralysis. Generally, brainstem hemorrhages are caused by hypertension, which must be well controlled.
The chances of regaining consciousness after brainstem hemorrhage
The probability of awakening from brainstem hemorrhage is generally only about 30%-45%, which is relatively low. This is because the brainstem is the most important center for circulation and respiration in the human body, as well as the awakening center. Awakening can be divided into two stages: the first stage is being able to eat, drink, and defecate independently; the second stage is being able to communicate normally with others. However, patients with brainstem hemorrhage, due to severe damage, may not even reach the first stage, meaning they may not even survive, and reaching the second stage is even more difficult. Therefore, it is essential to clearly understand the specific circumstances at the time, as awakening is generally a very unlikely event.
Can brainstem hemorrhage be treated abroad?
Patients with brainstem hemorrhage mostly have a risk factor of long-term hypertension, and they usually have poor blood pressure control. This results in small artery lesions, and under emotional excitement or severe fluctuations in blood pressure, bleeding in the brainstem occurs. Brainstem hemorrhage is quite dangerous; many patients who suffer from a significant amount of bleeding in the brainstem can fall into a coma, and some, even if their lives are saved, might end up with paralysis of the limbs or in a vegetative state. Currently, this is a global challenge, and brainstem hemorrhage is generally not advised to be treated surgically. However, some top experts both domestically and internationally have attempted surgical treatment for brainstem hemorrhage, and a portion of patients may see some effects from it, but generally speaking, most hospitals do not advocate for surgical treatment of brainstem hemorrhage. The treatment protocols for brainstem hemorrhage do not vary significantly between countries; the international treatment plans are quite similar.
How long do you have to stay in the ICU for a brainstem hemorrhage?
The length of stay in the ICU for brainstem hemorrhage depends entirely on the patient's specific condition. Generally, as long as the patient's breathing is stable and they can breathe on their own, and all other vital signs are relatively stable, they can be transferred out of the ICU. However, this depends on the patient's condition at the time. Many patients are admitted to the ICU typically due to poor breathing and lack of autonomous respiration. If a ventilator is used and the results improve, they may then be transferred out. Some may be out in a week, while others may need one to two months. It is also crucial to determine whether they have developed ventilator-associated pneumonia, lower limb venous thrombosis, or other more severe clinical manifestations, so decisions should be made based on these conditions for accuracy.
How long does it take to wake up from a brainstem hemorrhage?
Brainstem hemorrhage is a very serious condition. If the amount of bleeding in the brainstem increases, the patient will rapidly become comatose and exhibit symptoms such as paralysis of the limbs, inability to swallow, and inability to speak. Generally, if a patient with brainstem hemorrhage falls into a coma and cranial CT confirms a large amount of bleeding in the brainstem, the chances of the patient waking up are very, very slim. If the amount of brainstem hemorrhage is not particularly large and the patient's level of coma is not very deep, treatment may lead to the patient waking up, which could take about two to four weeks. However, the prognosis for brainstem hemorrhage is generally poor, and if the patient falls into a coma, they are usually unlikely to wake up. The treatment for brainstem hemorrhage mainly involves controlling blood pressure and preventing complications. If respiratory failure occurs, timely treatment with a ventilator is necessary. Overall, brainstem hemorrhage has a poor prognosis and high costs.