What does it mean to perform a tracheotomy on a patient with brainstem hemorrhage?

Written by Chen Yu Fei

Neurosurgery

Updated on September 22, 2024

00:00

00:00

In general, tracheostomy for brainstem hemorrhage refers to situations where the patient suffers from a degree of consciousness impairment, presenting in a state of stupor or coma, and it is anticipated that the patient's consciousness will not regain clarity in the short term. In such cases, we generally recommend performing a tracheostomy on the patient as soon as possible. Early tracheostomy can help smoothly suction deep phlegm and better protect lung function. Timely use of oxygen nebulization helps dilute the phlegm and promotes its expulsion, which is beneficial in preventing and treating pneumonia.

Other Voices

home-news-image

Written by Tang Li Li

Neurology

1min

home-news-image

Causes of brainstem hemorrhage convulsions

Seizures may occur due to a brainstem hemorrhage for several reasons, First, significant edema following a brainstem hemorrhage, combined with the mass effect of the hemorrhage itself, can lead to substantial compression of the brainstem, potentially resulting in tonic seizures. Second, the irritation from the hemorrhage could trigger symptomatic epilepsy, with the patient possibly experiencing partial new epileptic seizures that evolve into generalized tonic-clonic seizures. Third, the brainstem hemorrhage might cause high fever, which could induce febrile convulsions, also leading to seizures. Fourth, the treatment of brainstem hemorrhage often involves the use of high doses of diuretics. If severe dehydration occurs, it can lead to a state of excessive dehydration, electrolyte imbalance, and hyperosmolarity; high sodium levels might also trigger seizures.

home-news-image

Written by Li Qiang

Intensive Care Unit

48sec

home-news-image

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.

home-news-image

Written by Chen Yu Fei

Neurosurgery

50sec

home-news-image

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.

home-news-image

Written by Chen Yu Fei

Neurosurgery

46sec

home-news-image

The critical period for brainstem hemorrhage is several days.

For patients with brainstem hemorrhage, the first week after the onset is a critical period. During this time, the bleeding may gradually increase, and secondary cerebral edema may occur, leading to dysfunction of the brainstem and even respiratory and circulatory failure, which can endanger the patient's life. Therefore, for these patients, it is crucial to closely monitor any changes in their condition, transfer them to the intensive care unit, and closely monitor their vital signs. Special attention should be paid to the patient's blood pressure, respiration, heart rate, pupil reactions, consciousness, and limb activity. Dynamic follow-up head CT scans should be performed to observe any changes in the condition.

home-news-image

Written by Jiang Fang Shuai

Neurosurgery

52sec

home-news-image

sequelae of brainstem hemorrhage

All the different sequelae of cerebral hemorrhage can potentially occur after a brainstem hemorrhage. This is because the brainstem is a critical link between the brain and the body, acting as the command center within the headquarters. Of course, whether sequelae will occur and which ones will occur after a brainstem hemorrhage primarily depends on the amount of bleeding and the location of the bleed. If the bleeding in the brainstem is minor and occurs in a less critical area, the sequelae are usually minimal, and some people might not experience any sequelae at all. However, if there is substantial bleeding in the brainstem and the area affected is crucial, the patient may remain comatose for a long period. Even if they are revived and regain consciousness, they may suffer from severe functional impairments and experience numerous sequelae.