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 Gao Yi Shen
Neurosurgery
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Symptoms and signs of brainstem hemorrhage

The symptoms and signs of brainstem hemorrhage must be judged based on the situation. There are many nerve fibers in the brainstem, and bleeding in any area could lead to different clinical manifestations. The most common general symptoms include headache, nausea, dizziness, vomiting, and numbness and weakness in the limbs, and even conditions such as drowsiness, stupor, and even coma may occur. If more severe, it could cause abnormal rhythms in heart and respiratory functions, and some special symptoms might appear. For example, hemorrhage in the midbrain might cause bilateral pupil constriction, especially pinpoint constriction; if the hemorrhage occurs in the medulla, it could cause respiratory and circulatory arrest early on.

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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.

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Written by Chen Yu Fei
Neurosurgery
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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.

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Written by Gao Yi Shen
Neurosurgery
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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.

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Written by Zhang Hui
Neurology
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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.