Is vomiting severe in brainstem hemorrhage?

Written by Li Qiang
Intensive Care Unit
Updated on November 25, 2024
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Vomiting after brainstem hemorrhage is definitely a serious matter because if the vomiting is caused by a brain-related issue, it is due to increased intracranial pressure. This type of vomiting is characterized as projectile vomiting, which is one of the three major signs of increased intracranial pressure. If the brainstem hemorrhage is extensive, it may cause local stimulation leading to cerebral vascular spasm, or issues such as obstructed brain circulation resulting in increased intracranial pressure and hydrocephalus. This increase in intracranial pressure, especially if prolonged, can lead to brain herniation, which is particularly deadly if it compresses the brainstem. Therefore, this is a very urgent and serious condition that requires immediate attention. Of course, if the vomiting is solely due to other reasons such as gastric retention or improper feeding, that would be a different matter. Projectile vomiting caused by increased intracranial pressure is highly severe.

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Signs before death from brainstem hemorrhage

For patients with brainstem hemorrhage, if the patient's life is in danger, they often exhibit some special clinical manifestations. For example, the patient may present with apparent consciousness disturbances, characterized by moderate to severe coma states. In this state, the patient is unaware, unable to open their eyes or speak. When subjected to strong painful stimuli on their limbs, there is often no significant response, or it may just cause muscle twitching. Additionally, patients with brainstem hemorrhage may exhibit severe disturbances in vital signs as they approach death, characterized by shallow, rapid, and weakening spontaneous breathing, sometimes even ceasing, often requiring ventilator support. Also, difficulty in maintaining blood pressure may lead to a sudden drop in pressure or even shock.

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Written by Gao Yi Shen
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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.

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Written by Chen Yu Fei
Neurosurgery
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How long can someone with brainstem hemorrhage and hemiplegia survive?

Patients with brainstem hemorrhage presenting with hemiplegia have varying life expectancies, which depend on their primary diseases. In cases of severe brainstem hemorrhage, extensive bleeding typically causes significant damage to brainstem functions. Patients often remain in a prolonged comatose state, which can even threaten their lives. However, if the brainstem hemorrhage is minor and accompanied by mild limb hemiplegia, it generally does not pose a significant threat to the patient's life. It is crucial to administer medication treatment promptly after the hemorrhage and to start early rehabilitation exercises for the affected limbs. If patients persistently continue these exercises, they often achieve good treatment outcomes and can enjoy a long-term, high-quality life.

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Written by Jiang Fang Shuai
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Can brainstem hemorrhage be operated on?

The brainstem is the center of human life, controlling vital functions such as breathing, circulation, heart rate, and blood pressure. Once bleeding occurs, patients often experience unstable vital signs, deep coma, and can die from brain function failure within a short period. Previously, it was believed that the brainstem was a no-go zone for surgery, and treatment for brainstem hemorrhage was primarily conservative medical therapy. However, with the continuous improvement of medical technology, neurosurgery departments in many top-tier hospitals have made significant achievements in minimally invasive or open surgeries for brainstem hemorrhages. Therefore, surgery for brainstem hemorrhage is not impossible and can be considered under specific circumstances.

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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.