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Brainstem hemorrhage
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.
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.
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.
What fruits to eat for brainstem hemorrhage
For patients experiencing brainstem hemorrhage, during the acute phase, if the patient shows significant swallowing dysfunction, it is not appropriate to eat fruits. Instead, you can wait until the patient's condition is stable. At that point, fruits can be juiced, and most of the pulp can be filtered out using a sieve. The fresh juice can be given to the patient to drink. However, it is important to note that if the patient has significant difficulty swallowing and coughs while drinking, this method is not suitable. Once the patient's condition stabilizes, it may be appropriate to gradually introduce some fresh fruits. Common fruits available in the market, such as apples, bananas, and oranges, are usually suitable. It's best to avoid or limit consumption of certain special fruits like durian or mango.
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.
Is brainstem hemorrhage serious?
Brainstem hemorrhage is caused by the rupture of small blood vessels in the brainstem, with common causes including hypertension, cerebral arteriosclerosis, vascular degeneration, and microaneurysms of vessels. Clinically, it manifests as sudden onset of consciousness impairment, confusion, coma or deep coma, accompanied by disorders of limb sensory and motor functions, eye movement disorders, and unstable vital signs, among others. If the hemorrhage occurs in the medulla, it can cause death by stopping the patient's heartbeat and breathing within a short period. Brainstem hemorrhage is a severe condition in neurology, and treatment focuses on bed rest to stop bleeding, reducing intracranial pressure, and treating complications. Despite advances in modern medicine, medical professionals often find themselves powerless in the face of many patients with brainstem hemorrhage. For brainstem hemorrhages with more than three milliliters of blood, most patients ultimately succumb to the condition. Therefore, brainstem hemorrhage is a very serious disease with a very high mortality rate in clinical settings.
How to exercise swallowing after a brainstem hemorrhage
Patients with brainstem hemorrhage often have critical conditions. Therefore, after stabilizing their condition, their swallowing function is usually severely impaired. During swallowing training, besides the common use of medications and acupuncture treatment, professional swallowing therapists in a formal rehabilitation medicine department conduct training on swallowing functions. Before starting swallowing training, an accurate assessment of swallowing function is typically conducted first. Swallowing disorders are divided into four stages: the preparatory stage, the oral stage, the pharyngeal stage, and the esophageal stage. In the preparatory stage, coordinating the consistency of the food can aid the patient's swallowing. Proper stimulation of the oral and pharyngeal muscles, including stimulation of the tongue and pharyngeal wall muscles, cold therapy, tongue pressure training, and training of the muscles around the mouth, are used to help restore swallowing function. During the esophageal stage, when the patient's condition has stabilized, videofluoroscopic swallow study can be carried out to assess specific issues in the esophageal stage, which are often related to cricopharyngeal dysfunction. Esophageal dilation with a balloon may also be used. With these accurate assessments and appropriate training, the swallowing function of patients generally shows significant improvement. Therefore, when patients experience these swallowing dysfunctions, it is best to seek treatment from a formal rehabilitation medicine department for better care.
What should the blood pressure control be for brainstem hemorrhage?
For patients with brainstem hemorrhage, it is important to maintain stable blood pressure after the bleeding. The ideal blood pressure should be controlled between 130/80 and 140/90. This is because the blood pressure should not be controlled too low. If the blood pressure is too low, it can lead to insufficient perfusion pressure in the brain tissue or brainstem, thus exacerbating the state of brain tissue ischemia and hypoxia, which may aggravate the local brainstem ischemia and cause new brainstem infarcts. Additionally, blood pressure should not be too high, as excessively high blood pressure can lead to primary brainstem hemorrhage, coagulation dysfunction, and situations where bleeding is difficult to stop. Moreover, it can cause rebleeding of the brainstem, also known as secondary hemorrhage, which, once it occurs, can be life-threatening for the patient.
The difference between brainstem hemorrhage and cerebral hemorrhage.
Cerebral hemorrhage refers to any bleeding caused by the rupture of cerebral blood vessels. Based on the location of the bleeding, there is hemorrhage in the cerebral lobes, thalamic hemorrhage, cerebellar hemorrhage, brainstem hemorrhage, and so on. Consequently, brainstem hemorrhage is a type of cerebral hemorrhage. Because the brainstem is the life center of humans, even a small amount of bleeding can lead to severe consequences, and may even cause death. Therefore, brainstem hemorrhage is one of the most dangerous types of cerebral hemorrhage and has a very high rate of mortality and disability in clinical settings.
Why would there be bleeding in the brainstem?
Firstly, hemorrhaging can occur anywhere there are blood vessels. The brainstem is an important functional area of the human brain, connecting the cerebrum above and the spinal cord below, with the cerebellum closely positioned behind it. It serves as a crucial relay station for neural connections. This area is the control center of human life, managing vital functions such as breathing and heartbeat. Additionally, this area is densely packed with blood vessels. For patients with chronic hypertension, unstable blood pressure control can lead to degeneration and necrosis of the vessels, and even the formation of dissecting aneurysms or microaneurysms, which can cause the vessels to rupture and bleed under certain conditions. Like the vessels in other parts of the intracranial space, the blood vessels in the brainstem can also bleed. This is referred to as brainstem hemorrhage.