What will happen with brainstem hemorrhage?

Written by Zhang Hui
Neurology
Updated on December 16, 2024
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Brainstem hemorrhage is a very dangerous disease because the structure of the brainstem is so crucial. It contains the life centers responsible for breathing and heartbeat, as well as sensory and motor nerve fibers passing through it. If the brainstem hemorrhage is severe and the amount of bleeding is large, the patient may experience paralysis of the limbs, swallowing dysfunction, and choking on water, among other symptoms. If the condition worsens, it can lead to coma, persistent high fever, and even death. Patients with minor brainstem hemorrhages may exhibit symptoms such as dizziness, nausea, vomiting, numbness in the limbs, and paralysis. Generally, brainstem hemorrhages are caused by hypertension, which must be well controlled.

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The difference between brainstem hemorrhage and cerebral hemorrhage.

Cerebral hemorrhage refers to any bleeding caused by the rupture of cerebral blood vessels. Based on the location of the bleeding, there is hemorrhage in the cerebral lobes, thalamic hemorrhage, cerebellar hemorrhage, brainstem hemorrhage, and so on. Consequently, brainstem hemorrhage is a type of cerebral hemorrhage. Because the brainstem is the life center of humans, even a small amount of bleeding can lead to severe consequences, and may even cause death. Therefore, brainstem hemorrhage is one of the most dangerous types of cerebral hemorrhage and has a very high rate of mortality and disability in clinical settings.

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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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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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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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sequelae of brainstem hemorrhage

All the different sequelae of cerebral hemorrhage can potentially occur after a brainstem hemorrhage. This is because the brainstem is a critical link between the brain and the body, acting as the command center within the headquarters. Of course, whether sequelae will occur and which ones will occur after a brainstem hemorrhage primarily depends on the amount of bleeding and the location of the bleed. If the bleeding in the brainstem is minor and occurs in a less critical area, the sequelae are usually minimal, and some people might not experience any sequelae at all. However, if there is substantial bleeding in the brainstem and the area affected is crucial, the patient may remain comatose for a long period. Even if they are revived and regain consciousness, they may suffer from severe functional impairments and experience numerous sequelae.