What to do if there is fever due to brainstem hemorrhage?

Written by Chen Yu Fei

Neurosurgery

Updated on July 02, 2025

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When a patient exhibits brainstem hemorrhage accompanied by fever, it is crucial to promptly monitor their body temperature and assess the extent of the temperature increase. If the temperature rises above 38.5 degrees Celsius, it is recommended to treat the patient with antipyretic medications. Clinically, it is generally recommended to use Nimodipine dispersible tablets or administer Amobarbital via muscular injection for treatment. Additionally, it is essential to employ physical methods of cooling at areas of arterial blood vessel concentration on the patient's body surface, such as considering the use of alcohol or warm water baths, or placing ice packs on major arterial sites to effectively achieve physical cooling. (Please use the above medications under the guidance of a doctor, and do not self-medicate blindly.)

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Written by Chen Yu Fei

Neurosurgery

48sec

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Brainstem hemorrhage CT imaging findings

For patients with brainstem hemorrhage, a head CT generally shows irregular high-density shadows in the brainstem area, which are mostly seen in acute fresh brainstem hemorrhages. When the condition of brainstem hemorrhage is relatively stable, low-density shadows may appear around the high-density shadows, which at this time are considered to be due to the presence of surrounding edema. When the patient's condition is stable, a follow-up CT of the brainstem one to two weeks later often shows a gradual reduction in the density of the original high-density shadows, indicating that the hematoma of the brainstem hemorrhage has entered the hematoma absorption phase. In the later stable condition of the disease, as the hematoma is gradually absorbed, the density will also gradually decrease.

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Written by Chen Yu Fei

Neurosurgery

50sec

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Signs before death from brainstem hemorrhage

For patients with brainstem hemorrhage, if the patient's life is in danger, they often exhibit some special clinical manifestations. For example, the patient may present with apparent consciousness disturbances, characterized by moderate to severe coma states. In this state, the patient is unaware, unable to open their eyes or speak. When subjected to strong painful stimuli on their limbs, there is often no significant response, or it may just cause muscle twitching. Additionally, patients with brainstem hemorrhage may exhibit severe disturbances in vital signs as they approach death, characterized by shallow, rapid, and weakening spontaneous breathing, sometimes even ceasing, often requiring ventilator support. Also, difficulty in maintaining blood pressure may lead to a sudden drop in pressure or even shock.

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Written by Zhang Hui

Neurology

1min 6sec

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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 Jiang Fang Shuai

Neurosurgery

55sec

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Causes of brainstem hemorrhage

The causes of brainstem hemorrhage mainly include the following aspects: The first aspect is hypertension; arteriosclerosis is the most important cause of brainstem hemorrhage because prolonged high blood pressure and continuous impact of blood flow easily lead to damage and disease of the blood vessels, forming small aneurysms. These aneurysms eventually rupture, causing brainstem bleeding. The second aspect is vascular malformations in the brainstem area, which are another major cause of bleeding. Most patients under 40 with normal blood pressure and no coagulation disorders can find vascular malformations in the brainstem area after undergoing DSA examinations following brainstem hemorrhage. The third aspect is heavy drinking leading to increased blood pressure, impaired liver function, abnormal coagulation, etc., ultimately causing bleeding in the brainstem area.

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Written by Chen Yu Fei

Neurosurgery

49sec

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Is it normal to have a high fever with brainstem hemorrhage?

Patients with brainstem hemorrhage who develop a high fever may have several possible causes. Firstly, it might be due to absorption heat, but in such cases, the body temperature generally does not exceed 38.5 degrees Celsius. If there is recurrent fever, accompanied by coughing, expectoration, yellow and sticky sputum that is difficult to expel, it is mostly considered likely to be a pulmonary infection, in which case the body temperature generally exceeds 38.5 degrees Celsius, and high fever occurs. Additionally, it is important to note that once fever occurs, antipyretic medications should be administered to the patient to help lower the body temperature. Physical methods such as using warm water or rubbing alcohol for baths can also be used to reduce the temperature.