Brainstem hemorrhage is what?

Written by Chen Yu Fei
Neurosurgery
Updated on January 30, 2025
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There are many causes of brainstem hemorrhage, and clinically, it is mostly considered to be caused by hypertensive cerebral hemorrhage. Patients have a history of hypertension and have not received regular and effective antihypertensive treatment, leading to suboptimal blood pressure control. Excessively high blood pressure often results in the weakening or even disappearance of the patient's own vascular regulatory functions. Under certain triggering factors, such as fatigue, exhaustion, mental stress, or overly intense emotions, the blood pressure within the vessels may exceed their own regulatory capabilities, making bleeding more likely. If the bleeding occurs in the brainstem, it manifests as a brainstem hemorrhage. In some patients, brainstem hemorrhages are caused by conditions like cavernous angiomas, aneurysms, or arteriovenous malformations.

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Written by Chen Yu Fei
Neurosurgery
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How to rehabilitate from brainstem hemorrhage?

For patients with brainstem hemorrhage, it is often recommended during the acute phase to treat them with medications for hemostasis, brain enhancement, nerve nutrition, dehydration to reduce intracranial pressure, and inhibition of gastric acid. It is also important to actively treat complications and comorbidities caused by the brainstem hemorrhage. For these patients, when the condition is stable, appropriate rehabilitation exercises should be carried out. For patients with hemiplegia or aphasia, rehabilitation exercises can be done on the affected limbs, and speech rehabilitation training can help improve current conditions of hemiplegia and aphasia. Additionally, for these patients, active and passive massage of the limbs should be initiated early to prevent muscle atrophy and joint stiffness.

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Written by Chen Yu Fei
Neurosurgery
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What will happen after waking up from a brainstem hemorrhage?

For patients suffering from brainstem hemorrhage, when they are conscious, they often exhibit symptoms of neurological dysfunction. For instance, many patients may experience mild cognitive impairments, such as a decline in memory, as well as a noticeable decrease in learning and calculation abilities. Some patients might lose language functions or display significant aphasia, including anomia, motor aphasia, or mixed aphasia. Additionally, some patients may concurrently suffer from dysphagia, characterized by frequent coughing episodes when drinking fluids. Furthermore, some patients may exhibit specific symptoms or signs of limb motor dysfunction. Such patients typically require ongoing effective treatment.

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Written by Jiang Fang Shuai
Neurosurgery
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How long is the period of brainstem hemorrhagic edema?

Brainstem hemorrhage, like hemorrhages in other parts of the brain, also has a period of cerebral edema. Cerebral edema is primarily caused by direct injury to brain tissue following hemorrhage, local ischemic and hypoxic changes, local metabolic products, and some damage to the vascular endothelium. Generally, the edema becomes apparent three days after the hemorrhage, peaks between three to seven days, begins to subside after ten days, and completely resolves around fourteen to fifteen days. However, there are exceptions, such as cases where edema occurs shortly after injury or within a few hours, and the peak period of edema lasts for several weeks, or even up to a month without complete resolution.

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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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How long does it take for a brainstem hemorrhage clot to be absorbed?

In general, the absorption time for a brainstem hemorrhage clot is around two to three weeks. During this period, several phases must be passed, with the two main ones being the rebleeding phase and the brain swelling phase. Rebleeding often occurs within three days after the initial bleeding. If not treated promptly during this time, it can easily lead to further brainstem hemorrhage, increasing the size of the clot and hindering the later absorption process. The second phase is the peak of brain swelling and vasospasm. During this phase, certain substances released during the absorption of blood vessels and clots can cause swelling and spasms of the surrounding tissues. If this phase is also safely navigated, then subsequent absorption tends to be relatively quicker. However, complete absorption generally requires at least two to three weeks.