Is a brainstem hemorrhage serious?

Written by Jiang Fang Shuai
Neurosurgery
Updated on August 31, 2024
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Brainstem hemorrhage is a type of cerebral hemorrhage, occurring within the brainstem, which is the central hub of human life. Thus, once a brainstem hemorrhage occurs, the condition becomes extremely complicated and severe, with very high mortality and disability rates. Clinically, brainstem hemorrhages of less than three milliliters have a mortality rate close to 70%. Those exceeding five milliliters have a mortality rate close to 90%, and hemorrhages over ten milliliters are invariably fatal. In recent years, there has been an increasing trend in brainstem hemorrhages, affecting younger populations. This is mainly due to high work stress, uncontrolled diet, lack of exercise, and notably, a lack of awareness and attention to hypertension among young people, which ultimately leads to brainstem hemorrhage. Brainstem hemorrhage is a very dangerous disease.

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Written by Zhang Hui
Neurology
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Pre-symptoms of brainstem hemorrhage

Brainstem hemorrhage is extremely dangerous, and once a massive hemorrhage occurs, the patient can quickly lose consciousness and generally there are no effective emergency measures available. The patient will quickly die due to the involvement of the centers controlling heartbeat and breathing. The early symptoms of brainstem hemorrhage are not particularly obvious, but a careful medical history may reveal that patients often experience excessive fatigue, stress, emotional agitation, and poor sleep before the hemorrhage. Patients may show early signs such as dizziness, blurred vision, double vision, limb weakness, and slurred speech. If a patient has very high blood pressure and exhibits these early symptoms, especially if there is discomfort in the neck and upper back area, it is crucial to be highly vigilant and seek immediate medical attention. The prognosis for brainstem hemorrhage is very poor, thus it is essential to focus on preventive measures and properly control blood pressure.

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Written by Chen Yu Fei
Neurosurgery
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Is brainstem hemorrhage painful?

Brainstem hemorrhage is relatively painful, and most patients with brainstem hemorrhage will exhibit severe headaches and dizziness. The nature of the pain is intense, resembling a cutting pain that is hard to tolerate. However, when the amount of bleeding is large, it can quickly cause damage to important nerve nuclei in the brainstem, and even affect the central nervous system responsible for consciousness, leading to the patient falling into a stupor or coma. In such cases, the patient may not feel pain, but for those who are conscious, severe headaches and dizziness, accompanied by a strong sense of vertigo, especially noticeable when changing positions, often occur.

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Written by Zhang Hui
Neurology
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How long does it take to wake up from a brainstem hemorrhage?

Brainstem hemorrhage is a very serious condition. If the amount of bleeding in the brainstem increases, the patient will rapidly become comatose and exhibit symptoms such as paralysis of the limbs, inability to swallow, and inability to speak. Generally, if a patient with brainstem hemorrhage falls into a coma and cranial CT confirms a large amount of bleeding in the brainstem, the chances of the patient waking up are very, very slim. If the amount of brainstem hemorrhage is not particularly large and the patient's level of coma is not very deep, treatment may lead to the patient waking up, which could take about two to four weeks. However, the prognosis for brainstem hemorrhage is generally poor, and if the patient falls into a coma, they are usually unlikely to wake up. The treatment for brainstem hemorrhage mainly involves controlling blood pressure and preventing complications. If respiratory failure occurs, timely treatment with a ventilator is necessary. Overall, brainstem hemorrhage has a poor prognosis and high costs.

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Written by Chen Yu Fei
Neurosurgery
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Can you survive with 10 milliliters of bleeding in the brainstem?

A brainstem hemorrhage of 10 milliliters is relatively significant; whether the patient can survive depends on specific circumstances. First, it must be determined if the hemorrhage has compressed important neural nuclei, causing apparent respiratory and circulatory dysfunction. If such dysfunction occurs, it could severely threaten the patient's life. Additionally, the patient's level of consciousness and the availability of timely and effective treatment, along with necessary life support, must be considered. For example, if respiratory and circulatory dysfunction arises, it might be appropriate to use vasopressors to maintain blood pressure and ventilators to assist breathing. If effective life support is available, it is often possible to survive the peak period of swelling and preserve life.

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

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.