The difference between brainstem hemorrhage and cerebral hemorrhage.

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 25, 2024
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Cerebral hemorrhage refers to any bleeding caused by the rupture of cerebral blood vessels. Based on the location of the bleeding, there is hemorrhage in the cerebral lobes, thalamic hemorrhage, cerebellar hemorrhage, brainstem hemorrhage, and so on. Consequently, brainstem hemorrhage is a type of cerebral hemorrhage. Because the brainstem is the life center of humans, even a small amount of bleeding can lead to severe consequences, and may even cause death. Therefore, brainstem hemorrhage is one of the most dangerous types of cerebral hemorrhage and has a very high rate of mortality and disability in clinical settings.

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Written by Jiang Fang Shuai
Neurosurgery
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Is a brainstem hemorrhage serious?

Brainstem hemorrhage is a type of cerebral hemorrhage, occurring within the brainstem, which is the central hub of human life. Thus, once a brainstem hemorrhage occurs, the condition becomes extremely complicated and severe, with very high mortality and disability rates. Clinically, brainstem hemorrhages of less than three milliliters have a mortality rate close to 70%. Those exceeding five milliliters have a mortality rate close to 90%, and hemorrhages over ten milliliters are invariably fatal. In recent years, there has been an increasing trend in brainstem hemorrhages, affecting younger populations. This is mainly due to high work stress, uncontrolled diet, lack of exercise, and notably, a lack of awareness and attention to hypertension among young people, which ultimately leads to brainstem hemorrhage. Brainstem hemorrhage is a very dangerous disease.

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Written by Zhang Hui
Neurology
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What should not be eaten in case of brainstem hemorrhage?

Firstly, patients with brainstem hemorrhage should avoid eating foods that are difficult to digest. This is because these patients can easily develop acute gastric mucosal lesions, leading to decreased gastrointestinal function. If they consume harder foods, it could increase the burden on their digestive function, which is detrimental to recovery. Secondly, patients with brainstem hemorrhage should also avoid cold items, such as drinking cold beverages or eating ice cream, as these can easily cause diarrhea. Thirdly, patients with brainstem hemorrhage should not eat overly salty foods, such as pickles, salted meat, salted fish, and so on. These items can cause an increase in blood pressure, potentially exacerbating the brainstem hemorrhage. Fourthly, avoid overly greasy foods as they can increase blood lipids, which is also unfavorable for the recovery from a brainstem hemorrhage. Fifthly, patients with brainstem hemorrhage should not smoke or drink alcohol, as these have no beneficial effect on their condition and could instead accelerate the progression of the disease.

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Written by Gao Yi Shen
Neurosurgery
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Brainstem hemorrhage blood pressure control range

The range of blood pressure control for brainstem hemorrhage must be specifically judged based on the current medical condition at the time. Generally speaking, it is optimal to maintain the systolic blood pressure between 110-120 mmHg. This can both ensure normal cerebral blood supply and reduce the risk of recurrent cerebral hemorrhage due to high blood pressure. However, each patient's baseline blood pressure is different, and many patients have a baseline systolic pressure higher than 180 mmHg. In such cases, it might be appropriate to adjust the target slightly higher, for instance around 130 mmHg. It is recognized that no one’s blood pressure can be perfectly consistent, so a certain degree of fluctuation is acceptable. Unless there are long-lasting high values, in which case, control within a certain range might be needed.

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Written by Zhang Hui
Neurology
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Pre-symptoms of brainstem hemorrhage

Brainstem hemorrhage is extremely dangerous, and once a massive hemorrhage occurs, the patient can quickly lose consciousness and generally there are no effective emergency measures available. The patient will quickly die due to the involvement of the centers controlling heartbeat and breathing. The early symptoms of brainstem hemorrhage are not particularly obvious, but a careful medical history may reveal that patients often experience excessive fatigue, stress, emotional agitation, and poor sleep before the hemorrhage. Patients may show early signs such as dizziness, blurred vision, double vision, limb weakness, and slurred speech. If a patient has very high blood pressure and exhibits these early symptoms, especially if there is discomfort in the neck and upper back area, it is crucial to be highly vigilant and seek immediate medical attention. The prognosis for brainstem hemorrhage is very poor, thus it is essential to focus on preventive measures and properly control blood pressure.

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Written by Gao Yi Shen
Neurosurgery
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Precursor warnings of brainstem hemorrhage

The warning signs of brainstem hemorrhage must be analyzed according to the situation. Clinically, many people have induced brainstem hemorrhage due to straining during defecation or becoming emotionally agitated during arguments. It is quite common for someone to suddenly collapse and become unconscious after an argument, which is likely indicative of a brainstem hemorrhage. Additionally, one may experience severe headaches without any obvious triggers, along with numbness or weakness in the limbs and speech impairments. Furthermore, signs of coma often appear. If a patient's coma is accompanied by pinpoint pupils, it is crucial to get them to a hospital for appropriate examinations immediately, as this is very likely a precursor to brainstem hemorrhage.