Brainstem hemorrhage is what?

Written by Chen Yu Fei
Neurosurgery
Updated on January 30, 2025
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There are many causes of brainstem hemorrhage, and clinically, it is mostly considered to be caused by hypertensive cerebral hemorrhage. Patients have a history of hypertension and have not received regular and effective antihypertensive treatment, leading to suboptimal blood pressure control. Excessively high blood pressure often results in the weakening or even disappearance of the patient's own vascular regulatory functions. Under certain triggering factors, such as fatigue, exhaustion, mental stress, or overly intense emotions, the blood pressure within the vessels may exceed their own regulatory capabilities, making bleeding more likely. If the bleeding occurs in the brainstem, it manifests as a brainstem hemorrhage. In some patients, brainstem hemorrhages are caused by conditions like cavernous angiomas, aneurysms, or arteriovenous malformations.

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Written by Huang Lei
Physical Medicine and Rehabilitation
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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.

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Written by Zhang Hui
Neurology
1min 8sec home-news-image

How to rescue brainstem hemorrhage?

Brainstem hemorrhage is an extremely dangerous disease. Patients typically have a long history of hypertension, and their blood pressure is not particularly well-controlled. The onset of the condition is sudden, and if the bleeding is extensive, it can quickly lead to unconsciousness and even respiratory and cardiac failure, resulting in death. It is crucial to rush the patient to the nearest hospital for emergency treatment to avoid aggravating the brainstem hemorrhage due to bumps during a long transport. Generally, the patient should be kept in a supine position, and if they are still conscious, it is vital to keep their emotions stable. Additionally, it is necessary to ensure the airway remains clear. If respiratory failure occurs, ventilation can be provided. Medications that reduce intracranial pressure can be administered to alleviate brainstem edema. Furthermore, respiratory stimulant drugs can be given to ensure breathing. Overall, the mortality rate for brainstem hemorrhages is exceedingly high, with a lack of particularly effective emergency measures.

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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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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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Key Points in Nursing Care for Patients with Brainstem Hemorrhage

For patients with brainstem hemorrhage, due to the special location of the bleeding which affects crucial neural functions, these patients often need to be transferred to the intensive care unit (ICU) for examination and treatment. In the ICU, close observation of changes in the patient's condition is essential, along with monitoring vital signs including blood pressure, respiration, heart rate, and blood oxygen saturation. Nursing care should focus on the patient's pupils, consciousness, and limb activity. It is necessary to manage and stabilize the patient’s blood pressure, blood sugar, and blood lipids through medication, regularly draw blood, and analyze the patient’s biochemical system to prevent severe water and electrolyte disturbances.