Is a high fever serious with brainstem hemorrhage?

Written by Chen Yu Fei
Neurosurgery
Updated on March 27, 2025
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For patients with brainstem hemorrhage who develop a high fever, it is first necessary to consider that the hemorrhage has affected vital central nervous system functions, leading to central fever. In such cases, the fever typically exceeds 38.5 degrees Celsius, and may even reach high fevers of 39 to 40 degrees Celsius, which are difficult to reduce with ordinary antipyretic drugs. Additionally, some patients with brainstem hemorrhage may also have concurrent lung infections, which can lead to recurrent high fevers exceeding 38.5 degrees Celsius. In such situations, it is advisable to perform a blood test for routine blood work. Furthermore, it is also important to monitor for any local inflammation, auscultate the lungs, and determine if the lung sounds are coarser or if there are any dry or wet rales in both lungs.

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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 Tang Ying
Physical Medicine and Rehabilitation
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How long is the edema period for brainstem hemorrhage?

The edema phase of the brain stem generally lasts for two to three weeks, with the peak of swelling occurring around seven to ten days. For some patients, the swelling completely subsides nearly a month later. Only after the peak of the swelling has passed can patients be out of life-threatening danger. As the swelling gradually subsides, the patient's consciousness, vital signs, limb movements, eating, and other symptoms will also gradually improve. Once patients get through the swelling phase, we can start early bedside rehabilitation as soon as possible. In addition to using some drugs that nourish brain nerves, passive limb movements, proper limb positioning, early exercise, and acupuncture can all be started early to accelerate the patient's early rehabilitation and prevent complications such as muscle atrophy, relaxation, and dependent pneumonia, which can be improved early on.

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Written by Chen Yu Fei
Neurosurgery
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Recovery of consciousness from brainstem hemorrhage takes several days.

For patients with brainstem hemorrhage, how many days it takes to regain consciousness depends on the location of the bleeding and the amount of bleeding. If the amount of bleeding is small, the patient's consciousness often gradually awakens within 24 to 48 hours. There may be short-term language impairments, manifesting as unclear speech, difficulty speaking, articulation disorders, and accompanied by significant swallowing difficulties, indicated by choking on water, but this will gradually improve over time. If the bleeding is substantial, it often leads to the patient being in a coma for a long time, and may even enter a vegetative state for an extended period, unable to regain autonomous consciousness.

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Written by Chen Yu Fei
Neurosurgery
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Is brainstem hemorrhage prone to recurrence?

Bleeding in the brainstem area, if not well controlled and treated, is very prone to recurrence. In most cases, considering that patients have underlying diseases such as hypertension and diabetes, and do not control their blood pressure and blood sugar well, resulting in prolonged high levels of blood pressure and blood sugar, such conditions can easily lead to the recurrence of brainstem hemorrhage. Therefore, it is recommended to monitor blood pressure in the morning and evening, take antihypertensive medications on time, and keep the patient's blood pressure within a relatively stable range. Additionally, it is suggested to follow a light diet, low in salt and fat, and to regularly revisit the local hospital for a thorough monitoring of the patient’s vital signs.

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Written by Gao Yi Shen
Neurosurgery
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Chance of rescue for brainstem hemorrhage

The chances of successfully treating brainstem hemorrhages vary greatly, as they are closely related to the location and amount of the hemorrhage in the brainstem. Generally speaking, the chance of completely successful treatment of a brainstem hemorrhage is only about 10%, with many cases leaving significant sequelae or leading to clinical death. Particularly in the case of medulla oblongata hemorrhages, even a minimal bleed of 5ml can be extremely critical, as it can immediately cause cessation of both respiration and circulation. This is because this area is crucial for the operation of vital neurological functions and is very delicate; once damaged, it could potentially lead to death. Therefore, it is essential to clearly determine the exact location and volume of the brainstem hemorrhage, as only then can the probability of successful treatment be more accurately calculated.