How to administer first aid for brainstem hemorrhage

Written by Chen Yu Fei
Neurosurgery
Updated on January 30, 2025
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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 Zhang Hui
Neurology
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How long does it take to wake up from a brainstem hemorrhage?

Brainstem hemorrhage is a very serious condition. If the amount of bleeding in the brainstem increases, the patient will rapidly become comatose and exhibit symptoms such as paralysis of the limbs, inability to swallow, and inability to speak. Generally, if a patient with brainstem hemorrhage falls into a coma and cranial CT confirms a large amount of bleeding in the brainstem, the chances of the patient waking up are very, very slim. If the amount of brainstem hemorrhage is not particularly large and the patient's level of coma is not very deep, treatment may lead to the patient waking up, which could take about two to four weeks. However, the prognosis for brainstem hemorrhage is generally poor, and if the patient falls into a coma, they are usually unlikely to wake up. The treatment for brainstem hemorrhage mainly involves controlling blood pressure and preventing complications. If respiratory failure occurs, timely treatment with a ventilator is necessary. Overall, brainstem hemorrhage has a poor prognosis and high costs.

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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.

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Written by Li Qiang
Intensive Care Unit
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Why does gastric bleeding also occur when there is bleeding in the brainstem?

This brainstem hemorrhage, as well as other severe cranial traumas or cerebral hemorrhages, if they cause a severe intracranial hypertension, will lead to a condition called stress ulcer, commonly known as Cushing's ulcer. This occurs because the increased intracranial pressure causes ischemia and hypoxia in the gastric mucosa, which then leads to localized, extensive necrosis of the gastric mucosa, resulting in upper gastrointestinal bleeding. This includes brainstem hemorrhages and many other cranial injuries and cerebral hemorrhages with intracranial hypertension as a very common complication. Therefore, it is due to the local ischemia of the gastric mucosa caused by increased intracranial pressure, leading to bleeding caused by gastric acid corrosion.

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Written by Gao Yi Shen
Neurosurgery
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Brainstem hemorrhage blood pressure control range

The range of blood pressure control for brainstem hemorrhage must be specifically judged based on the current medical condition at the time. Generally speaking, it is optimal to maintain the systolic blood pressure between 110-120 mmHg. This can both ensure normal cerebral blood supply and reduce the risk of recurrent cerebral hemorrhage due to high blood pressure. However, each patient's baseline blood pressure is different, and many patients have a baseline systolic pressure higher than 180 mmHg. In such cases, it might be appropriate to adjust the target slightly higher, for instance around 130 mmHg. It is recognized that no one’s blood pressure can be perfectly consistent, so a certain degree of fluctuation is acceptable. Unless there are long-lasting high values, in which case, control within a certain range might be needed.

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Written by Chen Yu Fei
Neurosurgery
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How long can someone with brainstem hemorrhage and hemiplegia survive?

Patients with brainstem hemorrhage presenting with hemiplegia have varying life expectancies, which depend on their primary diseases. In cases of severe brainstem hemorrhage, extensive bleeding typically causes significant damage to brainstem functions. Patients often remain in a prolonged comatose state, which can even threaten their lives. However, if the brainstem hemorrhage is minor and accompanied by mild limb hemiplegia, it generally does not pose a significant threat to the patient's life. It is crucial to administer medication treatment promptly after the hemorrhage and to start early rehabilitation exercises for the affected limbs. If patients persistently continue these exercises, they often achieve good treatment outcomes and can enjoy a long-term, high-quality life.