The chances of regaining consciousness after brainstem hemorrhage

Written by Gao Yi Shen
Neurosurgery
Updated on December 15, 2024
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The probability of awakening from brainstem hemorrhage is generally only about 30%-45%, which is relatively low. This is because the brainstem is the most important center for circulation and respiration in the human body, as well as the awakening center. Awakening can be divided into two stages: the first stage is being able to eat, drink, and defecate independently; the second stage is being able to communicate normally with others. However, patients with brainstem hemorrhage, due to severe damage, may not even reach the first stage, meaning they may not even survive, and reaching the second stage is even more difficult. Therefore, it is essential to clearly understand the specific circumstances at the time, as awakening is generally a very unlikely event.

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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 Zhang Hui
Neurology
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What should not be eaten in case of brainstem hemorrhage?

Firstly, patients with brainstem hemorrhage should avoid eating foods that are difficult to digest. This is because these patients can easily develop acute gastric mucosal lesions, leading to decreased gastrointestinal function. If they consume harder foods, it could increase the burden on their digestive function, which is detrimental to recovery. Secondly, patients with brainstem hemorrhage should also avoid cold items, such as drinking cold beverages or eating ice cream, as these can easily cause diarrhea. Thirdly, patients with brainstem hemorrhage should not eat overly salty foods, such as pickles, salted meat, salted fish, and so on. These items can cause an increase in blood pressure, potentially exacerbating the brainstem hemorrhage. Fourthly, avoid overly greasy foods as they can increase blood lipids, which is also unfavorable for the recovery from a brainstem hemorrhage. Fifthly, patients with brainstem hemorrhage should not smoke or drink alcohol, as these have no beneficial effect on their condition and could instead accelerate the progression of the disease.

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Written by Chen Yu Fei
Neurosurgery
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How to administer first aid for brainstem hemorrhage

For patients with brainstem hemorrhage, once signs of brainstem hemorrhage are detected, the patient should be sent to the local hospital immediately for an emergency head CT scan to help determine the location and severity of the hemorrhage. Due to its special location, brainstem hemorrhage is often difficult to treat surgically in most cases. Once brainstem hemorrhage occurs, the patient should first be transferred to the intensive care unit for close monitoring of vital signs. At the same time, administer medications to stop bleeding, enhance brain function, nourish nerves, promote dehydration, and reduce intracranial pressure, while carefully observing changes in the patient's condition. During treatment, strictly prevent and treat various comorbidities or complications. (Please use medications under the guidance of a professional physician and do not self-medicate.)

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Written by Li Qiang
Intensive Care Unit
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Why does gastric bleeding also occur when there is bleeding in the brainstem?

This brainstem hemorrhage, as well as other severe cranial traumas or cerebral hemorrhages, if they cause a severe intracranial hypertension, will lead to a condition called stress ulcer, commonly known as Cushing's ulcer. This occurs because the increased intracranial pressure causes ischemia and hypoxia in the gastric mucosa, which then leads to localized, extensive necrosis of the gastric mucosa, resulting in upper gastrointestinal bleeding. This includes brainstem hemorrhages and many other cranial injuries and cerebral hemorrhages with intracranial hypertension as a very common complication. Therefore, it is due to the local ischemia of the gastric mucosa caused by increased intracranial pressure, leading to bleeding caused by gastric acid corrosion.

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Written by Chen Yu Fei
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How to prevent brainstem hemorrhage?

To prevent brainstem hemorrhage, it is first recommended that in daily life, if there are underlying diseases such as hypertension or diabetes, it is advisable to keep the patient's blood pressure and blood sugar levels within a stable range. Monitor blood pressure in the morning and evening, and take antihypertensive medication on time. When high blood pressure is detected, you should promptly visit the department of cardiology at the local hospital and ask the doctor to help regulate blood pressure to ensure its stability. In addition, it is recommended to develop good lifestyle habits in daily life, such as regular eating and sleeping, avoiding overwork, exhaustion, mental stress, and staying up late, while maintaining adequate sleep and good lifestyle habits to help prevent brainstem hemorrhage.