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

Written by Gao Yi Shen
Neurosurgery
Updated on November 15, 2024
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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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Written by Gao Yi Shen
Neurosurgery
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Can bleeding in the brainstem be saved?

The causes of brainstem hemorrhage can mainly be divided into three categories, The first category is caused by hypertensive factors, which are often the most common cause. The second category is caused by vascular diseases, among which cavernous hemangiomas and arteriovenous fistulas are most common. The third category includes relatively rare diseases, which should not be overlooked in clinical practice, such as tumoral factors. For these, specific examinations must be conducted to accurately determine the cause of the bleeding. Whether treatment is possible depends on the specific circumstances at the time. If the amount of bleeding is relatively small and the area affected is not a critical functional zone, such as the medulla, there is still a possibility of treatment later on. Active surgical and medical treatments can lead to healing later on. However, if the brainstem hemorrhage has already caused cessation of breathing and circulation, generally, there is no need for treatment as such conditions often lead to respiratory and circulatory failure, resulting in death.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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How long is the edema period for brainstem hemorrhage?

The edema phase of the brain stem generally lasts for two to three weeks, with the peak of swelling occurring around seven to ten days. For some patients, the swelling completely subsides nearly a month later. Only after the peak of the swelling has passed can patients be out of life-threatening danger. As the swelling gradually subsides, the patient's consciousness, vital signs, limb movements, eating, and other symptoms will also gradually improve. Once patients get through the swelling phase, we can start early bedside rehabilitation as soon as possible. In addition to using some drugs that nourish brain nerves, passive limb movements, proper limb positioning, early exercise, and acupuncture can all be started early to accelerate the patient's early rehabilitation and prevent complications such as muscle atrophy, relaxation, and dependent pneumonia, which can be improved early on.

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Written by Chen Yu Fei
Neurosurgery
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Is brainstem hemorrhage related to smoking?

Brainstem hemorrhage is somewhat related to smoking. For brainstem hemorrhage, smoking acts as a trigger. During the process of smoking, the nicotine in tobacco may cause constriction of the brain's blood vessels, leading to increased blood pressure. When blood pressure rises beyond the blood vessels' ability to regulate themselves, it often induces the vessels to rupture and bleed, resulting in a brainstem hemorrhage. Of course, for brainstem hemorrhage, smoking is just one triggering factor and not the sole cause. For these patients, the majority of cases are largely related to poor lifestyle habits, poor dietary habits, and the individual's underlying vascular conditions.

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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.

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Written by Chen Yu Fei
Neurosurgery
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Dietary Precautions for Brainstem Hemorrhage

For patients with brainstem hemorrhage, attention should be given to their diet. During the acute phase, it is advisable to choose a liquid diet, as most patients with brainstem hemorrhage often have severe swallowing dysfunction. Failing to choose a liquid diet can lead to aspiration, which in turn causes aspiration pneumonia. Furthermore, patients should avoid certain foods for a short period, particularly greasy or spicy foods, as most patients experience significant reductions in digestive function during the acute phase. If dietary intake is not carefully managed, patients often experience significant abdominal pain and diarrhea. Once the patient's condition stabilizes, it is appropriate to include fresh vegetables and fruits in their diet.