How is brainstem hemorrhage treated?

Written by Zhang Hui
Neurology
Updated on March 15, 2025
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Brainstem hemorrhage is extremely dangerous and must be treated as soon as possible. The treatment plan mainly includes: the patient must rest in bed, avoid emotional stimulation, ensure smooth bowel movements, and must strengthen turning over and patting the back to prevent serious complications such as bedsores and pulmonary infections. In terms of medication, it mainly involves providing drugs that protect brain cells and nourish brain nerves. Additionally, because patients with brainstem hemorrhage have high intracranial pressure, it is necessary to administer dehydrating drugs to reduce intracranial pressure. Moreover, once the patient's vital signs stabilize, treatments such as acupuncture and rehabilitation training are needed to promote the recovery of neural functions. If the patient experiences respiratory failure, it is necessary to promptly use a ventilator for treatment. Furthermore, patients with brainstem hemorrhage who are bedridden for a long period can develop complications such as pulmonary infections and urinary system infections. If these complications occur, timely use of antibiotics is necessary to control the complications.

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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.

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Written by Chen Yu Fei
Neurosurgery
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How long does it take for the fever to subside after a brainstem hemorrhage?

For patients with brainstem hemorrhage, it is common to develop high fever after the bleeding, where the body temperature often exceeds 38.5℃. There are many reasons for the occurrence of high fever. It can be considered that the presence of an intracerebral hematoma compresses the hypothalamic temperature set point, causing abnormalities in the set point function and leading to central fever, with temperatures often reaching 39℃ or even higher than 40℃. At this time, the use of antipyretic drugs alone generally has poor therapeutic effect. It often requires the effective absorption of the intracerebral hematoma for the body temperature to gradually return to normal. Another situation, considering the occurrence of pulmonary infection, it is necessary to promptly provide patients with antibiotics for effective treatment. When the pulmonary infection is effectively controlled, the body temperature will also gradually decrease.

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Written by Chen Yu Fei
Neurosurgery
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How does a brainstem hemorrhage clot get absorbed?

For patients with brainstem hemorrhage, edema generally enters the edema phase within 24 to 48 hours, and then gradually transitions into the absorption phase. During this period, it is first necessary to provide the patient with medications that enhance brain function, promote blood circulation and remove blood stasis, and nourish the nerves for treatment. At the same time, it is important to monitor changes in the patient's condition, and regularly perform a head CT scan to dynamically observe the changes in cerebral hematoma. In most cases, it is necessary to prevent various complications or concurrent diseases. If there is an abnormality in coagulation function, it is advisable to administer hemostatic drugs for treatment during the acute phase. However, once the patient's condition stabilizes, use medications that improve cerebral microcirculation and promote blood circulation and remove blood stasis for treatment.

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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.

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Written by Jiang Fang Shuai
Neurosurgery
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Can brainstem hemorrhage be operated on?

The brainstem is the center of human life, controlling vital functions such as breathing, circulation, heart rate, and blood pressure. Once bleeding occurs, patients often experience unstable vital signs, deep coma, and can die from brain function failure within a short period. Previously, it was believed that the brainstem was a no-go zone for surgery, and treatment for brainstem hemorrhage was primarily conservative medical therapy. However, with the continuous improvement of medical technology, neurosurgery departments in many top-tier hospitals have made significant achievements in minimally invasive or open surgeries for brainstem hemorrhages. Therefore, surgery for brainstem hemorrhage is not impossible and can be considered under specific circumstances.