How long can someone with brainstem hemorrhage and hemiplegia survive?

Written by Chen Yu Fei
Neurosurgery
Updated on September 03, 2024
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Patients with brainstem hemorrhage presenting with hemiplegia have varying life expectancies, which depend on their primary diseases. In cases of severe brainstem hemorrhage, extensive bleeding typically causes significant damage to brainstem functions. Patients often remain in a prolonged comatose state, which can even threaten their lives. However, if the brainstem hemorrhage is minor and accompanied by mild limb hemiplegia, it generally does not pose a significant threat to the patient's life. It is crucial to administer medication treatment promptly after the hemorrhage and to start early rehabilitation exercises for the affected limbs. If patients persistently continue these exercises, they often achieve good treatment outcomes and can enjoy a long-term, high-quality life.

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Written by Chen Yu Fei
Neurosurgery
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Is brainstem hemorrhage painful?

Brainstem hemorrhage is relatively painful, and most patients with brainstem hemorrhage will exhibit severe headaches and dizziness. The nature of the pain is intense, resembling a cutting pain that is hard to tolerate. However, when the amount of bleeding is large, it can quickly cause damage to important nerve nuclei in the brainstem, and even affect the central nervous system responsible for consciousness, leading to the patient falling into a stupor or coma. In such cases, the patient may not feel pain, but for those who are conscious, severe headaches and dizziness, accompanied by a strong sense of vertigo, especially noticeable when changing positions, often occur.

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Written by Zhang Hui
Neurology
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How to nourish the body after a brainstem hemorrhage

Brainstem hemorrhage is a very dangerous condition. If the bleeding is substantial, the patient may quickly fall into a coma or even die. If the bleeding is less severe, the prognosis might be relatively better. Patients with brainstem hemorrhage typically experience impaired swallowing functions, showing symptoms like inability to swallow food, difficulty in consuming water, and coughing while drinking. Therefore, it is crucial to supplement nutrition. Primarily, a feeding tube can be inserted for hydration and feeding, with the intake mainly consisting of easily digestible foods such as millet porridge, rice porridge, soybean juice, milk, etc. Additionally, it is important to supplement the patient with fresh vegetables and fruits to ensure an adequate supply of vitamin C. Furthermore, high-quality proteins like lean meat and beef should be provided to ensure adequate protein intake for patients with brainstem hemorrhage.

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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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How is brainstem hemorrhage treated?

Brainstem hemorrhage is extremely dangerous and must be treated as soon as possible. The treatment plan mainly includes: the patient must rest in bed, avoid emotional stimulation, ensure smooth bowel movements, and must strengthen turning over and patting the back to prevent serious complications such as bedsores and pulmonary infections. In terms of medication, it mainly involves providing drugs that protect brain cells and nourish brain nerves. Additionally, because patients with brainstem hemorrhage have high intracranial pressure, it is necessary to administer dehydrating drugs to reduce intracranial pressure. Moreover, once the patient's vital signs stabilize, treatments such as acupuncture and rehabilitation training are needed to promote the recovery of neural functions. If the patient experiences respiratory failure, it is necessary to promptly use a ventilator for treatment. Furthermore, patients with brainstem hemorrhage who are bedridden for a long period can develop complications such as pulmonary infections and urinary system infections. If these complications occur, timely use of antibiotics is necessary to control the complications.

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Written by Li Qiang
Intensive Care Unit
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Does it take five years to recover from brainstem hemorrhage?

The recovery period after a brainstem hemorrhage generally refers to the acute stage immediately following the bleeding, which is also the period at risk for rebleeding. This high-risk period typically lasts one to two days. Afterwards, there is a phase of brainstem edema, lasting about 14 days, generally around 7 to 10 days, and usually resolves after two weeks. As the bleeding slowly gets absorbed over time, it typically does not take 5 years. If the bleeding is being absorbed, this usually only takes a few weeks. Once the absorption of the bleed stabilizes, the patient's condition generally becomes relatively stable. If the patient has not woken up, the likeliness of waking up several weeks later is very low. If the patient does wake up, it usually happens within about two weeks, or the bleeding may have been very minor, possibly not even causing unconsciousness. Therefore, if it has been five years and the patient's state of consciousness has not recovered, the likelihood of recovery is extremely minimal, and it is unlikely that there will be any change.