Symptoms of brainstem hemorrhage

Written by Gao Yi Shen
Neurosurgery
Updated on February 13, 2025
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The symptoms of brainstem hemorrhage can vary from mild to severe, depending on the specific presentation of the patient. For instance, in milder cases, symptoms may include simple headaches, dizziness, nausea, and vomiting without other clinical symptoms, which can often be easily distinguished from cervical spondylosis. Therefore, timely clinical examinations are necessary to confirm these conditions, which are generally mild and usually do not threaten life. However, symptoms might gradually worsen, manifesting as numbness in the limbs and speech impairments, among others. Some individuals may experience seizures, characterized by convulsions of the limbs, frothing at the mouth, etc. If the hemorrhage becomes more severe, it can compress more brainstem neurons, leading to coma, lethargy, and potentially severe outcomes like dilated pupils, and sudden cessation of breathing and circulation.

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Written by Chen Yu Fei
Neurosurgery
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Can brainstem hemorrhage be cured?

For brainstem hemorrhages that have already occurred, the patient should be immediately taken to a local hospital. Initially, a cranial CT scan should be performed to determine the location and amount of bleeding in the brainstem. For minor brainstem hemorrhages, it is recommended to first use medication for treatment. This involves administering drugs that stop bleeding, enhance brain function, promote dehydration, and nourish the nerves, aiding in the gradual cessation of bleeding and the absorption of cerebral hematomas. Most patients can achieve very good treatment outcomes. However, if the brainstem hemorrhage is extensive, it often leads to severe brainstem dysfunction and typically has a poor prognosis.

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Written by Jiang Fang Shuai
Neurosurgery
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Causes of brainstem hemorrhage

The causes of brainstem hemorrhage mainly include the following aspects: The first aspect is hypertension; arteriosclerosis is the most important cause of brainstem hemorrhage because prolonged high blood pressure and continuous impact of blood flow easily lead to damage and disease of the blood vessels, forming small aneurysms. These aneurysms eventually rupture, causing brainstem bleeding. The second aspect is vascular malformations in the brainstem area, which are another major cause of bleeding. Most patients under 40 with normal blood pressure and no coagulation disorders can find vascular malformations in the brainstem area after undergoing DSA examinations following brainstem hemorrhage. The third aspect is heavy drinking leading to increased blood pressure, impaired liver function, abnormal coagulation, etc., ultimately causing bleeding in the brainstem area.

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Written by Gao Yi Shen
Neurosurgery
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Symptoms of brainstem hemorrhage

The symptoms of brainstem hemorrhage can vary from mild to severe, depending on the specific presentation of the patient. For instance, in milder cases, symptoms may include simple headaches, dizziness, nausea, and vomiting without other clinical symptoms, which can often be easily distinguished from cervical spondylosis. Therefore, timely clinical examinations are necessary to confirm these conditions, which are generally mild and usually do not threaten life. However, symptoms might gradually worsen, manifesting as numbness in the limbs and speech impairments, among others. Some individuals may experience seizures, characterized by convulsions of the limbs, frothing at the mouth, etc. If the hemorrhage becomes more severe, it can compress more brainstem neurons, leading to coma, lethargy, and potentially severe outcomes like dilated pupils, and sudden cessation of breathing and circulation.

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Written by Chen Yu Fei
Neurosurgery
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How to exercise balance after brainstem hemorrhage?

For patients with brainstem hemorrhage who exhibit significant limb motor dysfunction and reduced sense of balance, it is recommended to seek treatment at a well-known local tertiary hospital. Experienced rehabilitation therapists should assess the current condition and develop an individualized rehabilitation exercise plan based on the patient's condition. Gradually, they should begin exercise training, including training for limb balance capabilities. Patients who actively and effectively engage in exercise therapy often achieve good therapeutic effects, with gradual restoration of balance and strengthening of limb motor function, achieving relatively satisfactory treatment outcomes.

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Written by Gao Yi Shen
Neurosurgery
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The acute phase of brainstem hemorrhage lasts for several days.

The acute phase of brainstem hemorrhage generally lasts about two to three weeks, or 14 to 21 days, but it also needs to be specifically assessed based on the different conditions of the patient. If the hemorrhage in the brainstem is relatively severe and located in an important functional area, then the critical period may be appropriately extended. For example, if the hemorrhage is in the medulla oblongata and has already caused respiratory and circulatory failure, as well as unstable vital signs and a comatose state, then the critical period could even reach about one to two months, because it is often necessary to use a ventilator to assist breathing, and the patient's comatose state does not allow for full consciousness. However, for some brainstem hemorrhages, such as a small hemorrhage in the pons that only causes the clinical symptom of headache in the patient, the critical period is generally no more than two weeks. Thus, each patient's condition is different.