The critical period for brainstem hemorrhage is several days.

Written by Chen Yu Fei
Neurosurgery
Updated on May 31, 2025
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For patients with brainstem hemorrhage, the first week after the onset is a critical period. During this time, the bleeding may gradually increase, and secondary cerebral edema may occur, leading to dysfunction of the brainstem and even respiratory and circulatory failure, which can endanger the patient's life. Therefore, for these patients, it is crucial to closely monitor any changes in their condition, transfer them to the intensive care unit, and closely monitor their vital signs. Special attention should be paid to the patient's blood pressure, respiration, heart rate, pupil reactions, consciousness, and limb activity. Dynamic follow-up head CT scans should be performed to observe any changes in the condition.

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Written by Chen Yu Fei
Neurosurgery
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How long can someone with brainstem hemorrhage and hemiplegia survive?

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 of brainstem hemorrhage

The symptoms of brainstem hemorrhage can vary from mild to severe, depending on the specific presentation of the patient. For instance, in milder cases, symptoms may include simple headaches, dizziness, nausea, and vomiting without other clinical symptoms, which can often be easily distinguished from cervical spondylosis. Therefore, timely clinical examinations are necessary to confirm these conditions, which are generally mild and usually do not threaten life. However, symptoms might gradually worsen, manifesting as numbness in the limbs and speech impairments, among others. Some individuals may experience seizures, characterized by convulsions of the limbs, frothing at the mouth, etc. If the hemorrhage becomes more severe, it can compress more brainstem neurons, leading to coma, lethargy, and potentially severe outcomes like dilated pupils, and sudden cessation of breathing and circulation.

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Written by Chen Yu Fei
Neurosurgery
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Can you survive with 10 milliliters of bleeding in the brainstem?

A brainstem hemorrhage of 10 milliliters is relatively significant; whether the patient can survive depends on specific circumstances. First, it must be determined if the hemorrhage has compressed important neural nuclei, causing apparent respiratory and circulatory dysfunction. If such dysfunction occurs, it could severely threaten the patient's life. Additionally, the patient's level of consciousness and the availability of timely and effective treatment, along with necessary life support, must be considered. For example, if respiratory and circulatory dysfunction arises, it might be appropriate to use vasopressors to maintain blood pressure and ventilators to assist breathing. If effective life support is available, it is often possible to survive the peak period of swelling and preserve life.

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Written by Chen Yu Fei
Neurosurgery
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Key Points in Nursing Care for Patients with Brainstem Hemorrhage

For patients with brainstem hemorrhage, due to the special location of the bleeding which affects crucial neural functions, these patients often need to be transferred to the intensive care unit (ICU) for examination and treatment. In the ICU, close observation of changes in the patient's condition is essential, along with monitoring vital signs including blood pressure, respiration, heart rate, and blood oxygen saturation. Nursing care should focus on the patient's pupils, consciousness, and limb activity. It is necessary to manage and stabilize the patient’s blood pressure, blood sugar, and blood lipids through medication, regularly draw blood, and analyze the patient’s biochemical system to prevent severe water and electrolyte disturbances.

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Written by Tang Li Li
Neurology
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Is there any sensation before brainstem hemorrhage?

The most common cause of brainstem hemorrhage is generally hypertension. The mechanism by which hypertension causes bleeding is chronic long-term hypertension, leading to hyaline degeneration of the small arterial walls. Under the force of blood flow, these walls are prone to bulging, leading to the formation of microaneurysms. When blood pressure fluctuates sharply, especially when there is a significant increase, it can cause these microaneurysms to rupture, leading to bleeding. Thus, if there are noticeable symptoms before the hemorrhage, they are mostly due to a sudden increase in blood pressure. Patients often experience dizziness or headaches, sometimes along with blurred vision, and may be accompanied by nausea and vomiting, but most patients may not feel any abnormalities before the bleeding occurs.