How long does it take to wake up from a coma caused by brainstem hemorrhage?

Written by Gao Yi Shen
Neurosurgery
Updated on November 15, 2024
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The timing of awakening after a coma caused by a brainstem hemorrhage must be judged based on the situation. As brainstem hemorrhages are relatively severe, there is generally no possibility of awakening if the patient's breathing, heartbeat, and circulation are not stable. If the patient can breathe normally off a ventilator and has a normal heartbeat and other vital signs, and pupil responses are also normal, then typically, they may awaken within one to two weeks. However, recovery times vary from person to person depending on the specifics of the condition, the location of the hemorrhage, and the surrounding tissue involved. Therefore, assessments should be made based on specific clinical signs at the time. Particularly with hemorrhages in the medulla oblongata, once coma ensues, it's often impossible to fully awaken the patient, and many succumb to complications later on. Therefore, adequate psychological preparation is essential in clinical settings.

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Written by Jiang Fang Shuai
Neurosurgery
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Can brainstem hemorrhage be cured?

Brainstem hemorrhage is a very dangerous disease with poor prognosis and high mortality rate. Although the brainstem is very small, it contains almost all vital neurological functions. Once hemorrhage occurs, it can cause severe neurological dysfunction, and even lead to the patient's death due to cessation of heartbeat and breathing in a short period. So, can brainstem hemorrhage be cured? It mainly depends on the location of the hemorrhage, the amount of bleeding, and the clinical symptoms. Patients with less bleeding, hemorrhages closer to the upper end of the brainstem, and milder clinical symptoms have a better chance of recovery. However, those with more extensive bleeding, hemorrhages closer to the lower end of the brainstem, and more severe clinical symptoms have a lesser likelihood of recovery.

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Written by Jiang Fang Shuai
Neurosurgery
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Is brainstem hemorrhage serious?

Brainstem hemorrhage is caused by the rupture of small blood vessels in the brainstem, with common causes including hypertension, cerebral arteriosclerosis, vascular degeneration, and microaneurysms of vessels. Clinically, it manifests as sudden onset of consciousness impairment, confusion, coma or deep coma, accompanied by disorders of limb sensory and motor functions, eye movement disorders, and unstable vital signs, among others. If the hemorrhage occurs in the medulla, it can cause death by stopping the patient's heartbeat and breathing within a short period. Brainstem hemorrhage is a severe condition in neurology, and treatment focuses on bed rest to stop bleeding, reducing intracranial pressure, and treating complications. Despite advances in modern medicine, medical professionals often find themselves powerless in the face of many patients with brainstem hemorrhage. For brainstem hemorrhages with more than three milliliters of blood, most patients ultimately succumb to the condition. Therefore, brainstem hemorrhage is a very serious disease with a very high mortality rate in clinical settings.

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Written by Chen Yu Fei
Neurosurgery
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What does it mean to perform a tracheotomy on a patient with brainstem hemorrhage?

In general, tracheostomy for brainstem hemorrhage refers to situations where the patient suffers from a degree of consciousness impairment, presenting in a state of stupor or coma, and it is anticipated that the patient's consciousness will not regain clarity in the short term. In such cases, we generally recommend performing a tracheostomy on the patient as soon as possible. Early tracheostomy can help smoothly suction deep phlegm and better protect lung function. Timely use of oxygen nebulization helps dilute the phlegm and promotes its expulsion, which is beneficial in preventing and treating pneumonia.

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Written by Zhang Hui
Neurology
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What should not be eaten in case of brainstem hemorrhage?

Firstly, patients with brainstem hemorrhage should avoid eating foods that are difficult to digest. This is because these patients can easily develop acute gastric mucosal lesions, leading to decreased gastrointestinal function. If they consume harder foods, it could increase the burden on their digestive function, which is detrimental to recovery. Secondly, patients with brainstem hemorrhage should also avoid cold items, such as drinking cold beverages or eating ice cream, as these can easily cause diarrhea. Thirdly, patients with brainstem hemorrhage should not eat overly salty foods, such as pickles, salted meat, salted fish, and so on. These items can cause an increase in blood pressure, potentially exacerbating the brainstem hemorrhage. Fourthly, avoid overly greasy foods as they can increase blood lipids, which is also unfavorable for the recovery from a brainstem hemorrhage. Fifthly, patients with brainstem hemorrhage should not smoke or drink alcohol, as these have no beneficial effect on their condition and could instead accelerate the progression of the disease.

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Written by Tang Ying
Physical Medicine and Rehabilitation
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How to exercise swallowing after a brainstem hemorrhage

Patients with brainstem hemorrhage often have critical conditions. Therefore, after stabilizing their condition, their swallowing function is usually severely impaired. During swallowing training, besides the common use of medications and acupuncture treatment, professional swallowing therapists in a formal rehabilitation medicine department conduct training on swallowing functions. Before starting swallowing training, an accurate assessment of swallowing function is typically conducted first. Swallowing disorders are divided into four stages: the preparatory stage, the oral stage, the pharyngeal stage, and the esophageal stage. In the preparatory stage, coordinating the consistency of the food can aid the patient's swallowing. Proper stimulation of the oral and pharyngeal muscles, including stimulation of the tongue and pharyngeal wall muscles, cold therapy, tongue pressure training, and training of the muscles around the mouth, are used to help restore swallowing function. During the esophageal stage, when the patient's condition has stabilized, videofluoroscopic swallow study can be carried out to assess specific issues in the esophageal stage, which are often related to cricopharyngeal dysfunction. Esophageal dilation with a balloon may also be used. With these accurate assessments and appropriate training, the swallowing function of patients generally shows significant improvement. Therefore, when patients experience these swallowing dysfunctions, it is best to seek treatment from a formal rehabilitation medicine department for better care.