How long do you have to stay in the ICU for a brainstem hemorrhage?

Written by Gao Yi Shen
Neurosurgery
Updated on December 07, 2024
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The length of stay in the ICU for brainstem hemorrhage depends entirely on the patient's specific condition. Generally, as long as the patient's breathing is stable and they can breathe on their own, and all other vital signs are relatively stable, they can be transferred out of the ICU. However, this depends on the patient's condition at the time. Many patients are admitted to the ICU typically due to poor breathing and lack of autonomous respiration. If a ventilator is used and the results improve, they may then be transferred out. Some may be out in a week, while others may need one to two months. It is also crucial to determine whether they have developed ventilator-associated pneumonia, lower limb venous thrombosis, or other more severe clinical manifestations, so decisions should be made based on these conditions for accuracy.

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Written by Gao Yi Shen
Neurosurgery
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Precursor warnings of brainstem hemorrhage

The warning signs of brainstem hemorrhage must be analyzed according to the situation. Clinically, many people have induced brainstem hemorrhage due to straining during defecation or becoming emotionally agitated during arguments. It is quite common for someone to suddenly collapse and become unconscious after an argument, which is likely indicative of a brainstem hemorrhage. Additionally, one may experience severe headaches without any obvious triggers, along with numbness or weakness in the limbs and speech impairments. Furthermore, signs of coma often appear. If a patient's coma is accompanied by pinpoint pupils, it is crucial to get them to a hospital for appropriate examinations immediately, as this is very likely a precursor to brainstem hemorrhage.

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Written by Zhang Hui
Neurology
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How to nourish the body after a brainstem hemorrhage

Brainstem hemorrhage is a very dangerous condition. If the bleeding is substantial, the patient may quickly fall into a coma or even die. If the bleeding is less severe, the prognosis might be relatively better. Patients with brainstem hemorrhage typically experience impaired swallowing functions, showing symptoms like inability to swallow food, difficulty in consuming water, and coughing while drinking. Therefore, it is crucial to supplement nutrition. Primarily, a feeding tube can be inserted for hydration and feeding, with the intake mainly consisting of easily digestible foods such as millet porridge, rice porridge, soybean juice, milk, etc. Additionally, it is important to supplement the patient with fresh vegetables and fruits to ensure an adequate supply of vitamin C. Furthermore, high-quality proteins like lean meat and beef should be provided to ensure adequate protein intake for patients with brainstem hemorrhage.

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Written by Chen Yu Fei
Neurosurgery
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Brainstem hemorrhage CT imaging findings

For patients with brainstem hemorrhage, a head CT generally shows irregular high-density shadows in the brainstem area, which are mostly seen in acute fresh brainstem hemorrhages. When the condition of brainstem hemorrhage is relatively stable, low-density shadows may appear around the high-density shadows, which at this time are considered to be due to the presence of surrounding edema. When the patient's condition is stable, a follow-up CT of the brainstem one to two weeks later often shows a gradual reduction in the density of the original high-density shadows, indicating that the hematoma of the brainstem hemorrhage has entered the hematoma absorption phase. In the later stable condition of the disease, as the hematoma is gradually absorbed, the density will also gradually decrease.

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Written by Gao Yi Shen
Neurosurgery
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Brainstem hemorrhage blood pressure control range

The range of blood pressure control for brainstem hemorrhage must be specifically judged based on the current medical condition at the time. Generally speaking, it is optimal to maintain the systolic blood pressure between 110-120 mmHg. This can both ensure normal cerebral blood supply and reduce the risk of recurrent cerebral hemorrhage due to high blood pressure. However, each patient's baseline blood pressure is different, and many patients have a baseline systolic pressure higher than 180 mmHg. In such cases, it might be appropriate to adjust the target slightly higher, for instance around 130 mmHg. It is recognized that no one’s blood pressure can be perfectly consistent, so a certain degree of fluctuation is acceptable. Unless there are long-lasting high values, in which case, control within a certain range might be needed.

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Written by Gao Yi Shen
Neurosurgery
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How long does it take to wake up from a coma caused by brainstem hemorrhage?

The timing of awakening after a coma caused by a brainstem hemorrhage must be judged based on the situation. As brainstem hemorrhages are relatively severe, there is generally no possibility of awakening if the patient's breathing, heartbeat, and circulation are not stable. If the patient can breathe normally off a ventilator and has a normal heartbeat and other vital signs, and pupil responses are also normal, then typically, they may awaken within one to two weeks. However, recovery times vary from person to person depending on the specifics of the condition, the location of the hemorrhage, and the surrounding tissue involved. Therefore, assessments should be made based on specific clinical signs at the time. Particularly with hemorrhages in the medulla oblongata, once coma ensues, it's often impossible to fully awaken the patient, and many succumb to complications later on. Therefore, adequate psychological preparation is essential in clinical settings.