Rehabilitation of sequelae of brainstem hemorrhage

Written by Chen Yu Fei
Neurosurgery
Updated on April 24, 2025
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For patients with brainstem hemorrhage, there may be certain sequelae, such as obvious motor dysfunction of the limbs, like hemiplegia on one side. Additionally, some patients may also lose speech functions, manifested as motor aphasia or mixed aphasia. Most patients are likely to experience a decline in memory and have difficulty swallowing, often accompanied by coughing when drinking water. For these patients, post-recovery rehabilitation treatment becomes particularly crucial. During the recovery phase, effective rehabilitation exercises should be provided for the sequelae, such as rehabilitation exercises for motor functions of the affected limbs and speech function exercises.

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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 Tang Li Li
Neurology
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Causes of brainstem hemorrhage convulsions

Seizures may occur due to a brainstem hemorrhage for several reasons, First, significant edema following a brainstem hemorrhage, combined with the mass effect of the hemorrhage itself, can lead to substantial compression of the brainstem, potentially resulting in tonic seizures. Second, the irritation from the hemorrhage could trigger symptomatic epilepsy, with the patient possibly experiencing partial new epileptic seizures that evolve into generalized tonic-clonic seizures. Third, the brainstem hemorrhage might cause high fever, which could induce febrile convulsions, also leading to seizures. Fourth, the treatment of brainstem hemorrhage often involves the use of high doses of diuretics. If severe dehydration occurs, it can lead to a state of excessive dehydration, electrolyte imbalance, and hyperosmolarity; high sodium levels might also trigger seizures.

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Written by Gao Yi Shen
Neurosurgery
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Symptoms and signs of brainstem hemorrhage

The symptoms and signs of brainstem hemorrhage must be judged based on the situation. There are many nerve fibers in the brainstem, and bleeding in any area could lead to different clinical manifestations. The most common general symptoms include headache, nausea, dizziness, vomiting, and numbness and weakness in the limbs, and even conditions such as drowsiness, stupor, and even coma may occur. If more severe, it could cause abnormal rhythms in heart and respiratory functions, and some special symptoms might appear. For example, hemorrhage in the midbrain might cause bilateral pupil constriction, especially pinpoint constriction; if the hemorrhage occurs in the medulla, it could cause respiratory and circulatory arrest early on.

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Written by Li Qiang
Intensive Care Unit
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Where to massage for brainstem hemorrhage

Brainstem hemorrhage is a very serious condition. Once brainstem hemorrhage occurs, it can affect many vital centers, completely depending on the amount of bleeding. Even a few milliliters of bleeding in the brainstem can lead to very serious consequences, including the sudden cessation of breathing and heartbeat. Therefore, at this time, giving massages to someone with a brainstem hemorrhage is of little value, especially during the acute phase, as it is not suitable to engage them in physical activities. However, once the bleeding has stabilized and is not extensive, and if the person still has breathing and heartbeat functions, at this point, some passive limb movements can be performed. Turning the patient over can be beneficial for limb function, prevent muscle atrophy, maintain limb function, and also help prevent complications such as deep vein thrombosis in the lower limbs.

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Written by Zhang Hui
Neurology
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Is it dangerous to have a fever with brainstem hemorrhage?

Brainstem hemorrhage itself is a very dangerous disease. Patients with a large amount of bleeding generally find it difficult to recover and may even result in a vegetative state or death. The occurrence of fever in brainstem hemorrhage mainly has two reasons. First, brainstem hemorrhage can cause central fever, which is mainly due to damage to some autonomic nerves, leading to problems with the body's temperature regulation function. If central fever occurs, it is quite dangerous and indicates a poor prognosis, necessitating active physical cooling. Secondly, patients with brainstem hemorrhage are often in a comatose and bedridden state, making them highly susceptible to various complications, such as pulmonary infections and urinary system infections. If fever arises due to these infections, it also indicates a poor prognosis, with relatively high mortality and disability rates. Overall, the occurrence of fever in patients with brainstem hemorrhage is quite dangerous and indicates a poor prognosis.