What will happen with brainstem hemorrhage?

Written by Zhang Hui
Neurology
Updated on December 16, 2024
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Brainstem hemorrhage is a very dangerous disease because the structure of the brainstem is so crucial. It contains the life centers responsible for breathing and heartbeat, as well as sensory and motor nerve fibers passing through it. If the brainstem hemorrhage is severe and the amount of bleeding is large, the patient may experience paralysis of the limbs, swallowing dysfunction, and choking on water, among other symptoms. If the condition worsens, it can lead to coma, persistent high fever, and even death. Patients with minor brainstem hemorrhages may exhibit symptoms such as dizziness, nausea, vomiting, numbness in the limbs, and paralysis. Generally, brainstem hemorrhages are caused by hypertension, which must be well controlled.

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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 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 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 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 Chen Yu Fei
Neurosurgery
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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.