Chance of rescue for brainstem hemorrhage

Written by Gao Yi Shen
Neurosurgery
Updated on April 28, 2025
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The chances of successfully treating brainstem hemorrhages vary greatly, as they are closely related to the location and amount of the hemorrhage in the brainstem. Generally speaking, the chance of completely successful treatment of a brainstem hemorrhage is only about 10%, with many cases leaving significant sequelae or leading to clinical death. Particularly in the case of medulla oblongata hemorrhages, even a minimal bleed of 5ml can be extremely critical, as it can immediately cause cessation of both respiration and circulation. This is because this area is crucial for the operation of vital neurological functions and is very delicate; once damaged, it could potentially lead to death. Therefore, it is essential to clearly determine the exact location and volume of the brainstem hemorrhage, as only then can the probability of successful treatment be more accurately calculated.

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Written by Chen Yu Fei
Neurosurgery
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Is it normal to have a high fever with brainstem hemorrhage?

Patients with brainstem hemorrhage who develop a high fever may have several possible causes. Firstly, it might be due to absorption heat, but in such cases, the body temperature generally does not exceed 38.5 degrees Celsius. If there is recurrent fever, accompanied by coughing, expectoration, yellow and sticky sputum that is difficult to expel, it is mostly considered likely to be a pulmonary infection, in which case the body temperature generally exceeds 38.5 degrees Celsius, and high fever occurs. Additionally, it is important to note that once fever occurs, antipyretic medications should be administered to the patient to help lower the body temperature. Physical methods such as using warm water or rubbing alcohol for baths can also be used to reduce the temperature.

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Written by Chen Yu Fei
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Is brainstem hemorrhage painful?

Brainstem hemorrhage is relatively painful, and most patients with brainstem hemorrhage will exhibit severe headaches and dizziness. The nature of the pain is intense, resembling a cutting pain that is hard to tolerate. However, when the amount of bleeding is large, it can quickly cause damage to important nerve nuclei in the brainstem, and even affect the central nervous system responsible for consciousness, leading to the patient falling into a stupor or coma. In such cases, the patient may not feel pain, but for those who are conscious, severe headaches and dizziness, accompanied by a strong sense of vertigo, especially noticeable when changing positions, often occur.

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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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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 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.