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Brainstem hemorrhage
Can I drink fish soup with brainstem hemorrhage?
The patient experienced a brainstem hemorrhage, and if the bleeding is extensive, it's possible that the patient could be in a deep coma. In more severe cases, brain death could occur, where the patient would not be able to breathe on their own. Since the pathology mainly occurs in the brain, when the patient is in a coma, they are certainly not able to eat by themselves. At this time, feeding usually involves the insertion of a tube through the nose down to the stomach, called a nasogastric tube. Through this tube, food is delivered directly to the stomach, allowing for gastrointestinal nutrition. Commonly, the gastrointestinal function of such patients remains normal, so it is possible to administer liquid nutrition through the nasogastric tube, such as nutrient solutions or fish soup, without any issues.
How to rehabilitate through exercise after brainstem hemorrhage
Regarding the specific measures for rehabilitation exercises for brainstem hemorrhage, it is necessary to analyze specific problems based on the different conditions of the patients. Based on our past experience, several common symptoms of brainstem hemorrhage can be addressed with corresponding rehabilitation measures. The first one is swallowing disorder, which is very common in patients with brainstem hemorrhage. We can provide patients with electrical stimulation and ice stimulation, and teach them morning exercises such as cheek puffing, tongue stretching, and dry swallowing practices. The second common issue is articulation disorder, for which we can teach patients some speech training. Usually, we can prepare patients with rhythm, cadence, and deep breathing exercises for speech training. The third is the dysfunction of limb mobility. For specific activities, we need to conduct training, including some balance function training.
How does a brainstem hemorrhage clot get absorbed?
For patients with brainstem hemorrhage, edema generally enters the edema phase within 24 to 48 hours, and then gradually transitions into the absorption phase. During this period, it is first necessary to provide the patient with medications that enhance brain function, promote blood circulation and remove blood stasis, and nourish the nerves for treatment. At the same time, it is important to monitor changes in the patient's condition, and regularly perform a head CT scan to dynamically observe the changes in cerebral hematoma. In most cases, it is necessary to prevent various complications or concurrent diseases. If there is an abnormality in coagulation function, it is advisable to administer hemostatic drugs for treatment during the acute phase. However, once the patient's condition stabilizes, use medications that improve cerebral microcirculation and promote blood circulation and remove blood stasis for treatment.
Is brainstem hemorrhage related to smoking?
Brainstem hemorrhage is somewhat related to smoking. For brainstem hemorrhage, smoking acts as a trigger. During the process of smoking, the nicotine in tobacco may cause constriction of the brain's blood vessels, leading to increased blood pressure. When blood pressure rises beyond the blood vessels' ability to regulate themselves, it often induces the vessels to rupture and bleed, resulting in a brainstem hemorrhage. Of course, for brainstem hemorrhage, smoking is just one triggering factor and not the sole cause. For these patients, the majority of cases are largely related to poor lifestyle habits, poor dietary habits, and the individual's underlying vascular conditions.
Is it right to give up treatment for brainstem hemorrhage?
Brainstem hemorrhage discontinuing treatment could be appropriate in some cases. If the patient has extensive brainstem hemorrhage, particularly at the lower end of the brainstem, and has resulted in deep coma without response to any stimuli, with a Glasgow Coma Scale score of only 3, dilated pupils on both sides without any pupillary light reflex, and possibly no spontaneous breathing, the patient could be considered brain dead. According to international practice, treatment should not be pursued for patients who are brain dead, hence discontinuing treatment is appropriate for such patients. If the patient still has spontaneous breathing, then active resuscitation should be pursued, otherwise, it might be considered inhumane.
Does brainstem hemorrhage easily recur?
The main cause of brainstem hemorrhage is hypertension, which can lead to hyalinization in the arteries that supply the brainstem, and even the formation of small aneurysms. Under the impact of blood flow, these are prone to rupture, leading to hemorrhage in the brainstem. This is the primary mechanism of onset for brainstem hemorrhage. If the brainstem hemorrhage is caused by hypertension, maintaining good control of blood pressure and keeping it below the ideal level of 140-90 mmHg can prevent frequent recurrence, so there is no need for excessive worry, but it is crucial to monitor blood pressure regularly. Additionally, brainstem hemorrhages can also be caused by other reasons, such as cavernous hemangiomas or arteriovenous malformations. If brainstem hemorrhage is caused by these diseases, and the abnormal vessels are not surgically removed, recurrence is likely. Removing these abnormal vessels can greatly reduce the likelihood of recurrent brainstem hemorrhages.
What will happen after waking up from a brainstem hemorrhage?
For patients suffering from brainstem hemorrhage, when they are conscious, they often exhibit symptoms of neurological dysfunction. For instance, many patients may experience mild cognitive impairments, such as a decline in memory, as well as a noticeable decrease in learning and calculation abilities. Some patients might lose language functions or display significant aphasia, including anomia, motor aphasia, or mixed aphasia. Additionally, some patients may concurrently suffer from dysphagia, characterized by frequent coughing episodes when drinking fluids. Furthermore, some patients may exhibit specific symptoms or signs of limb motor dysfunction. Such patients typically require ongoing effective treatment.
How is brainstem hemorrhage caused?
There are many causes of brainstem hemorrhage, and in most clinical cases, it is seen in patients who have a history of hypertension and diabetes, and whose blood pressure and blood sugar have not been well controlled. Over time, due to prolonged high blood pressure or high blood sugar, arteriosclerotic changes occur in the vessels, and the vessels' own contractile function gradually declines. Under certain triggering factors, such as fatigue, exhaustion, mental stress, or excessive emotional excitement, the patient may experience transient dilation of the vessels, exceeding their regulatory capacity, which can lead to brainstem hemorrhage. Once brainstem hemorrhage occurs, it often leads to significant disturbances in consciousness within a short period, manifested as stupor or coma.
What will happen with brainstem hemorrhage?
Brainstem hemorrhage is a very dangerous disease because the structure of the brainstem is so crucial. It contains the life centers responsible for breathing and heartbeat, as well as sensory and motor nerve fibers passing through it. If the brainstem hemorrhage is severe and the amount of bleeding is large, the patient may experience paralysis of the limbs, swallowing dysfunction, and choking on water, among other symptoms. If the condition worsens, it can lead to coma, persistent high fever, and even death. Patients with minor brainstem hemorrhages may exhibit symptoms such as dizziness, nausea, vomiting, numbness in the limbs, and paralysis. Generally, brainstem hemorrhages are caused by hypertension, which must be well controlled.
The chances of regaining consciousness after brainstem hemorrhage
The probability of awakening from brainstem hemorrhage is generally only about 30%-45%, which is relatively low. This is because the brainstem is the most important center for circulation and respiration in the human body, as well as the awakening center. Awakening can be divided into two stages: the first stage is being able to eat, drink, and defecate independently; the second stage is being able to communicate normally with others. However, patients with brainstem hemorrhage, due to severe damage, may not even reach the first stage, meaning they may not even survive, and reaching the second stage is even more difficult. Therefore, it is essential to clearly understand the specific circumstances at the time, as awakening is generally a very unlikely event.