How to nourish the body after a brainstem hemorrhage

Written by Zhang Hui
Neurology
Updated on November 28, 2024
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Brainstem hemorrhage is a very dangerous condition. If the bleeding is substantial, the patient may quickly fall into a coma or even die. If the bleeding is less severe, the prognosis might be relatively better. Patients with brainstem hemorrhage typically experience impaired swallowing functions, showing symptoms like inability to swallow food, difficulty in consuming water, and coughing while drinking. Therefore, it is crucial to supplement nutrition. Primarily, a feeding tube can be inserted for hydration and feeding, with the intake mainly consisting of easily digestible foods such as millet porridge, rice porridge, soybean juice, milk, etc. Additionally, it is important to supplement the patient with fresh vegetables and fruits to ensure an adequate supply of vitamin C. Furthermore, high-quality proteins like lean meat and beef should be provided to ensure adequate protein intake for patients with brainstem hemorrhage.

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Written by Gao Yi Shen
Neurosurgery
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The acute phase of brainstem hemorrhage lasts for several days.

The acute phase of brainstem hemorrhage generally lasts about two to three weeks, or 14 to 21 days, but it also needs to be specifically assessed based on the different conditions of the patient. If the hemorrhage in the brainstem is relatively severe and located in an important functional area, then the critical period may be appropriately extended. For example, if the hemorrhage is in the medulla oblongata and has already caused respiratory and circulatory failure, as well as unstable vital signs and a comatose state, then the critical period could even reach about one to two months, because it is often necessary to use a ventilator to assist breathing, and the patient's comatose state does not allow for full consciousness. However, for some brainstem hemorrhages, such as a small hemorrhage in the pons that only causes the clinical symptom of headache in the patient, the critical period is generally no more than two weeks. Thus, each patient's condition is different.

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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 Chen Yu Fei
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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.

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Can brainstem hemorrhage be cured?

For brainstem hemorrhages that have already occurred, the patient should be immediately taken to a local hospital. Initially, a cranial CT scan should be performed to determine the location and amount of bleeding in the brainstem. For minor brainstem hemorrhages, it is recommended to first use medication for treatment. This involves administering drugs that stop bleeding, enhance brain function, promote dehydration, and nourish the nerves, aiding in the gradual cessation of bleeding and the absorption of cerebral hematomas. Most patients can achieve very good treatment outcomes. However, if the brainstem hemorrhage is extensive, it often leads to severe brainstem dysfunction and typically has a poor prognosis.

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How long is the period of brainstem hemorrhagic edema?

Brainstem hemorrhage, like hemorrhages in other parts of the brain, also has a period of cerebral edema. Cerebral edema is primarily caused by direct injury to brain tissue following hemorrhage, local ischemic and hypoxic changes, local metabolic products, and some damage to the vascular endothelium. Generally, the edema becomes apparent three days after the hemorrhage, peaks between three to seven days, begins to subside after ten days, and completely resolves around fourteen to fifteen days. However, there are exceptions, such as cases where edema occurs shortly after injury or within a few hours, and the peak period of edema lasts for several weeks, or even up to a month without complete resolution.