Is brainstem hemorrhage prone to recurrence?

Written by Chen Yu Fei
Neurosurgery
Updated on November 29, 2024
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Bleeding in the brainstem area, if not well controlled and treated, is very prone to recurrence. In most cases, considering that patients have underlying diseases such as hypertension and diabetes, and do not control their blood pressure and blood sugar well, resulting in prolonged high levels of blood pressure and blood sugar, such conditions can easily lead to the recurrence of brainstem hemorrhage. Therefore, it is recommended to monitor blood pressure in the morning and evening, take antihypertensive medications on time, and keep the patient's blood pressure within a relatively stable range. Additionally, it is suggested to follow a light diet, low in salt and fat, and to regularly revisit the local hospital for a thorough monitoring of the patient’s vital signs.

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Written by Chen Yu Fei
Neurosurgery
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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.

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Written by Chen Yu Fei
Neurosurgery
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Is brainstem hemorrhage prone to recurrence?

Bleeding in the brainstem area, if not well controlled and treated, is very prone to recurrence. In most cases, considering that patients have underlying diseases such as hypertension and diabetes, and do not control their blood pressure and blood sugar well, resulting in prolonged high levels of blood pressure and blood sugar, such conditions can easily lead to the recurrence of brainstem hemorrhage. Therefore, it is recommended to monitor blood pressure in the morning and evening, take antihypertensive medications on time, and keep the patient's blood pressure within a relatively stable range. Additionally, it is suggested to follow a light diet, low in salt and fat, and to regularly revisit the local hospital for a thorough monitoring of the patient’s vital signs.

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Written by Gao Yi Shen
Neurosurgery
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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.

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Written by Jiang Fang Shuai
Neurosurgery
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Causes of brainstem hemorrhage

The causes of brainstem hemorrhage mainly include the following aspects: The first aspect is hypertension; arteriosclerosis is the most important cause of brainstem hemorrhage because prolonged high blood pressure and continuous impact of blood flow easily lead to damage and disease of the blood vessels, forming small aneurysms. These aneurysms eventually rupture, causing brainstem bleeding. The second aspect is vascular malformations in the brainstem area, which are another major cause of bleeding. Most patients under 40 with normal blood pressure and no coagulation disorders can find vascular malformations in the brainstem area after undergoing DSA examinations following brainstem hemorrhage. The third aspect is heavy drinking leading to increased blood pressure, impaired liver function, abnormal coagulation, etc., ultimately causing bleeding in the brainstem area.

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Written by Shu Zhi Qiang
Neurosurgery
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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.