Key Points in Nursing Care for Patients with Brainstem Hemorrhage

Written by Chen Yu Fei
Neurosurgery
Updated on September 17, 2024
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For patients with brainstem hemorrhage, due to the special location of the bleeding which affects crucial neural functions, these patients often need to be transferred to the intensive care unit (ICU) for examination and treatment. In the ICU, close observation of changes in the patient's condition is essential, along with monitoring vital signs including blood pressure, respiration, heart rate, and blood oxygen saturation. Nursing care should focus on the patient's pupils, consciousness, and limb activity. It is necessary to manage and stabilize the patient’s blood pressure, blood sugar, and blood lipids through medication, regularly draw blood, and analyze the patient’s biochemical system to prevent severe water and electrolyte disturbances.

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Written by Chen Yu Fei
Neurosurgery
48sec home-news-image

Key Points in Nursing Care for Patients with Brainstem Hemorrhage

For patients with brainstem hemorrhage, due to the special location of the bleeding which affects crucial neural functions, these patients often need to be transferred to the intensive care unit (ICU) for examination and treatment. In the ICU, close observation of changes in the patient's condition is essential, along with monitoring vital signs including blood pressure, respiration, heart rate, and blood oxygen saturation. Nursing care should focus on the patient's pupils, consciousness, and limb activity. It is necessary to manage and stabilize the patient’s blood pressure, blood sugar, and blood lipids through medication, regularly draw blood, and analyze the patient’s biochemical system to prevent severe water and electrolyte disturbances.

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Written by Li Qiang
Intensive Care Unit
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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.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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How to exercise swallowing after a brainstem hemorrhage

Patients with brainstem hemorrhage often have critical conditions. Therefore, after stabilizing their condition, their swallowing function is usually severely impaired. During swallowing training, besides the common use of medications and acupuncture treatment, professional swallowing therapists in a formal rehabilitation medicine department conduct training on swallowing functions. Before starting swallowing training, an accurate assessment of swallowing function is typically conducted first. Swallowing disorders are divided into four stages: the preparatory stage, the oral stage, the pharyngeal stage, and the esophageal stage. In the preparatory stage, coordinating the consistency of the food can aid the patient's swallowing. Proper stimulation of the oral and pharyngeal muscles, including stimulation of the tongue and pharyngeal wall muscles, cold therapy, tongue pressure training, and training of the muscles around the mouth, are used to help restore swallowing function. During the esophageal stage, when the patient's condition has stabilized, videofluoroscopic swallow study can be carried out to assess specific issues in the esophageal stage, which are often related to cricopharyngeal dysfunction. Esophageal dilation with a balloon may also be used. With these accurate assessments and appropriate training, the swallowing function of patients generally shows significant improvement. Therefore, when patients experience these swallowing dysfunctions, it is best to seek treatment from a formal rehabilitation medicine department for better care.

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Written by Li Qiang
Intensive Care Unit
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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.

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Written by Tang Li Li
Neurology
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Is it dangerous to have a high fever with brainstem hemorrhage?

Brainstem hemorrhage is dangerous if accompanied by high fever. Brainstem hemorrhage itself is a severe disease, and patients often experience disturbances of consciousness, coma, and paralysis of limbs. The hemorrhage can damage the center that regulates body temperature, leading to central fever. After falling into a coma, patients may encounter problems with expectoration and swallowing, which can easily lead to aspiration pneumonia and hypostatic pneumonia. Infections can also cause high fever. Patients need to use diuretics to reduce intracranial pressure, but excessive dehydration can also lead to dehydration fever. High fever exacerbates the consumption of the patient's body, increasing the physical burden and potentially leading to multiple organ failure. It is necessary to control the fever as soon as possible, using both physical cooling methods and medication.