What will happen after waking up from a brainstem hemorrhage?

Written by Chen Yu Fei
Neurosurgery
Updated on December 21, 2024
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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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How to administer first aid for brainstem hemorrhage

For patients with brainstem hemorrhage, once signs of brainstem hemorrhage are detected, the patient should be sent to the local hospital immediately for an emergency head CT scan to help determine the location and severity of the hemorrhage. Due to its special location, brainstem hemorrhage is often difficult to treat surgically in most cases. Once brainstem hemorrhage occurs, the patient should first be transferred to the intensive care unit for close monitoring of vital signs. At the same time, administer medications to stop bleeding, enhance brain function, nourish nerves, promote dehydration, and reduce intracranial pressure, while carefully observing changes in the patient's condition. During treatment, strictly prevent and treat various comorbidities or complications. (Please use medications under the guidance of a professional physician and do not self-medicate.)

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Written by Gao Yi Shen
Neurosurgery
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Symptoms of brainstem hemorrhage

The symptoms of brainstem hemorrhage can vary from mild to severe, depending on the specific presentation of the patient. For instance, in milder cases, symptoms may include simple headaches, dizziness, nausea, and vomiting without other clinical symptoms, which can often be easily distinguished from cervical spondylosis. Therefore, timely clinical examinations are necessary to confirm these conditions, which are generally mild and usually do not threaten life. However, symptoms might gradually worsen, manifesting as numbness in the limbs and speech impairments, among others. Some individuals may experience seizures, characterized by convulsions of the limbs, frothing at the mouth, etc. If the hemorrhage becomes more severe, it can compress more brainstem neurons, leading to coma, lethargy, and potentially severe outcomes like dilated pupils, and sudden cessation of breathing and circulation.

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Written by Jiang Fang Shuai
Neurosurgery
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Can brainstem hemorrhage be operated on?

The brainstem is the center of human life, controlling vital functions such as breathing, circulation, heart rate, and blood pressure. Once bleeding occurs, patients often experience unstable vital signs, deep coma, and can die from brain function failure within a short period. Previously, it was believed that the brainstem was a no-go zone for surgery, and treatment for brainstem hemorrhage was primarily conservative medical therapy. However, with the continuous improvement of medical technology, neurosurgery departments in many top-tier hospitals have made significant achievements in minimally invasive or open surgeries for brainstem hemorrhages. Therefore, surgery for brainstem hemorrhage is not impossible and can be considered under specific circumstances.

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Written by Tang Li Li
Neurology
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What causes fever from brainstem hemorrhage?

Patients with brainstem hemorrhage experience fever generally for the following three reasons: First, infection. Patients with brainstem hemorrhage often have disturbances of consciousness and dysfunction of the throat, and are bedridden, which frequently leads to aspiration pneumonia and hypostatic pneumonia. This is due to weakened ability to clear phlegm, as well as choking caused by saliva and feeding. Additionally, infections can easily occur in the gastrointestinal tract, urinary tract, and from skin pressure sores. Second, abnormalities in the temperature set point cause central hyperthermia. In patients with brainstem hemorrhage, the temperature regulation center is damaged. If the temperature regulating center sets the body temperature above 38 degrees Celsius, it often persists and cannot be reduced, and medications are poorly effective in lowering the temperature, necessitating the use of ice packs for physical cooling. Third, patients with brainstem hemorrhage often use large doses of diuretics. Dehydration after diuretic use can put patients in a state of excessive dehydration. If rehydration therapy is not adequately managed, dehydration fever can easily occur.

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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.