How long does it take for the fever to subside after a brainstem hemorrhage?

Written by Chen Yu Fei
Neurosurgery
Updated on January 27, 2025
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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 Jiang Fang Shuai
Neurosurgery
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The difference between brainstem hemorrhage and cerebral hemorrhage.

Cerebral hemorrhage refers to any bleeding caused by the rupture of cerebral blood vessels. Based on the location of the bleeding, there is hemorrhage in the cerebral lobes, thalamic hemorrhage, cerebellar hemorrhage, brainstem hemorrhage, and so on. Consequently, brainstem hemorrhage is a type of cerebral hemorrhage. Because the brainstem is the life center of humans, even a small amount of bleeding can lead to severe consequences, and may even cause death. Therefore, brainstem hemorrhage is one of the most dangerous types of cerebral hemorrhage and has a very high rate of mortality and disability in clinical settings.

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Written by Li Qiang
Intensive Care Unit
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Does it take five years to recover from brainstem hemorrhage?

The recovery period after a brainstem hemorrhage generally refers to the acute stage immediately following the bleeding, which is also the period at risk for rebleeding. This high-risk period typically lasts one to two days. Afterwards, there is a phase of brainstem edema, lasting about 14 days, generally around 7 to 10 days, and usually resolves after two weeks. As the bleeding slowly gets absorbed over time, it typically does not take 5 years. If the bleeding is being absorbed, this usually only takes a few weeks. Once the absorption of the bleed stabilizes, the patient's condition generally becomes relatively stable. If the patient has not woken up, the likeliness of waking up several weeks later is very low. If the patient does wake up, it usually happens within about two weeks, or the bleeding may have been very minor, possibly not even causing unconsciousness. Therefore, if it has been five years and the patient's state of consciousness has not recovered, the likelihood of recovery is extremely minimal, and it is unlikely that there will be any change.

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Written by Jiang Fang Shuai
Neurosurgery
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sequelae of brainstem hemorrhage

All the different sequelae of cerebral hemorrhage can potentially occur after a brainstem hemorrhage. This is because the brainstem is a critical link between the brain and the body, acting as the command center within the headquarters. Of course, whether sequelae will occur and which ones will occur after a brainstem hemorrhage primarily depends on the amount of bleeding and the location of the bleed. If the bleeding in the brainstem is minor and occurs in a less critical area, the sequelae are usually minimal, and some people might not experience any sequelae at all. However, if there is substantial bleeding in the brainstem and the area affected is crucial, the patient may remain comatose for a long period. Even if they are revived and regain consciousness, they may suffer from severe functional impairments and experience numerous sequelae.

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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 Zhang Hui
Neurology
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Is brainstem hemorrhage prone to recurrence?

Brainstem hemorrhage is perilous, and its recurrence largely depends on the cause and the management of risk factors. For instance, one significant cause of brainstem hemorrhage is the presence of certain arterial-venous malformations and sponge-like angiomas. Such conditions tend to recur if not surgically addressed promptly by removing these abnormal vessels, thereby reducing the likelihood of recurrence. Additionally, hypertension is the most common cause of brainstem hemorrhage. Long-term high blood pressure can damage arterial walls and lead to ruptures and bleeding. Stable control of blood pressure, alongside a low-salt, low-fat diet, can prevent recurrence of brainstem hemorrhage. However, poorly controlled blood pressure, resulting in severe fluctuations, can significantly increase the risk of recurrence.