Is brainstem hemorrhage dangerous?

Written by Jiang Fang Shuai
Neurosurgery
Updated on September 10, 2024
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The brainstem is the central hub of life in the human body, controlling vital functions such as blood pressure, pulse, respiration, body temperature, and consciousness. Bleeding in this area is extremely dangerous and is a life-threatening condition. Clinically, it has a high mortality and disability rate. For hemorrhages larger than 5 mL, most patients will succumb to central respiratory and circulatory failure within 48 hours. Even if the bleeding is less than 5 mL, although aggressive resuscitation may save the patient's life, most will suffer from severe brain dysfunction such as hemiplegia, aphasia, or a vegetative state. Therefore, brainstem hemorrhage is very dangerous.

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Written by Chen Yu Fei
Neurosurgery
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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.

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Written by Li Qiang
Intensive Care Unit
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Does it take five years to recover from brainstem hemorrhage?

The recovery period after a brainstem hemorrhage generally refers to the acute stage immediately following the bleeding, which is also the period at risk for rebleeding. This high-risk period typically lasts one to two days. Afterwards, there is a phase of brainstem edema, lasting about 14 days, generally around 7 to 10 days, and usually resolves after two weeks. As the bleeding slowly gets absorbed over time, it typically does not take 5 years. If the bleeding is being absorbed, this usually only takes a few weeks. Once the absorption of the bleed stabilizes, the patient's condition generally becomes relatively stable. If the patient has not woken up, the likeliness of waking up several weeks later is very low. If the patient does wake up, it usually happens within about two weeks, or the bleeding may have been very minor, possibly not even causing unconsciousness. Therefore, if it has been five years and the patient's state of consciousness has not recovered, the likelihood of recovery is extremely minimal, and it is unlikely that there will be any change.

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Written by Jiang Fang Shuai
Neurosurgery
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Can brainstem hemorrhage be cured?

Brainstem hemorrhage is a very dangerous disease with poor prognosis and high mortality rate. Although the brainstem is very small, it contains almost all vital neurological functions. Once hemorrhage occurs, it can cause severe neurological dysfunction, and even lead to the patient's death due to cessation of heartbeat and breathing in a short period. So, can brainstem hemorrhage be cured? It mainly depends on the location of the hemorrhage, the amount of bleeding, and the clinical symptoms. Patients with less bleeding, hemorrhages closer to the upper end of the brainstem, and milder clinical symptoms have a better chance of recovery. However, those with more extensive bleeding, hemorrhages closer to the lower end of the brainstem, and more severe clinical symptoms have a lesser likelihood of recovery.

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Written by Tang Ying
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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.

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Written by Gao Yi Shen
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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.