What causes fever from brainstem hemorrhage?

Written by Tang Li Li
Neurology
Updated on January 28, 2025
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Patients with brainstem hemorrhage experience fever generally for the following three reasons: First, infection. Patients with brainstem hemorrhage often have disturbances of consciousness and dysfunction of the throat, and are bedridden, which frequently leads to aspiration pneumonia and hypostatic pneumonia. This is due to weakened ability to clear phlegm, as well as choking caused by saliva and feeding. Additionally, infections can easily occur in the gastrointestinal tract, urinary tract, and from skin pressure sores. Second, abnormalities in the temperature set point cause central hyperthermia. In patients with brainstem hemorrhage, the temperature regulation center is damaged. If the temperature regulating center sets the body temperature above 38 degrees Celsius, it often persists and cannot be reduced, and medications are poorly effective in lowering the temperature, necessitating the use of ice packs for physical cooling. Third, patients with brainstem hemorrhage often use large doses of diuretics. Dehydration after diuretic use can put patients in a state of excessive dehydration. If rehydration therapy is not adequately managed, dehydration fever can easily occur.

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How long does it take to wake up from a coma caused by brainstem hemorrhage?

The timing of awakening after a coma caused by a brainstem hemorrhage must be judged based on the situation. As brainstem hemorrhages are relatively severe, there is generally no possibility of awakening if the patient's breathing, heartbeat, and circulation are not stable. If the patient can breathe normally off a ventilator and has a normal heartbeat and other vital signs, and pupil responses are also normal, then typically, they may awaken within one to two weeks. However, recovery times vary from person to person depending on the specifics of the condition, the location of the hemorrhage, and the surrounding tissue involved. Therefore, assessments should be made based on specific clinical signs at the time. Particularly with hemorrhages in the medulla oblongata, once coma ensues, it's often impossible to fully awaken the patient, and many succumb to complications later on. Therefore, adequate psychological preparation is essential in clinical settings.

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Is a high fever serious with brainstem hemorrhage?

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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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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Can brainstem hemorrhage be cured?

Brainstem hemorrhage is a very dangerous disease with poor prognosis and high mortality rate. Although the brainstem is very small, it contains almost all vital neurological functions. Once hemorrhage occurs, it can cause severe neurological dysfunction, and even lead to the patient's death due to cessation of heartbeat and breathing in a short period. So, can brainstem hemorrhage be cured? It mainly depends on the location of the hemorrhage, the amount of bleeding, and the clinical symptoms. Patients with less bleeding, hemorrhages closer to the upper end of the brainstem, and milder clinical symptoms have a better chance of recovery. However, those with more extensive bleeding, hemorrhages closer to the lower end of the brainstem, and more severe clinical symptoms have a lesser likelihood of recovery.

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Does brainstem hemorrhage easily recur?

The main cause of brainstem hemorrhage is hypertension, which can lead to hyalinization in the arteries that supply the brainstem, and even the formation of small aneurysms. Under the impact of blood flow, these are prone to rupture, leading to hemorrhage in the brainstem. This is the primary mechanism of onset for brainstem hemorrhage. If the brainstem hemorrhage is caused by hypertension, maintaining good control of blood pressure and keeping it below the ideal level of 140-90 mmHg can prevent frequent recurrence, so there is no need for excessive worry, but it is crucial to monitor blood pressure regularly. Additionally, brainstem hemorrhages can also be caused by other reasons, such as cavernous hemangiomas or arteriovenous malformations. If brainstem hemorrhage is caused by these diseases, and the abnormal vessels are not surgically removed, recurrence is likely. Removing these abnormal vessels can greatly reduce the likelihood of recurrent brainstem hemorrhages.