How to rehabilitate through exercise after brainstem hemorrhage

Written by Huang Lei
Physical Medicine and Rehabilitation
Updated on January 08, 2025
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Regarding the specific measures for rehabilitation exercises for brainstem hemorrhage, it is necessary to analyze specific problems based on the different conditions of the patients. Based on our past experience, several common symptoms of brainstem hemorrhage can be addressed with corresponding rehabilitation measures. The first one is swallowing disorder, which is very common in patients with brainstem hemorrhage. We can provide patients with electrical stimulation and ice stimulation, and teach them morning exercises such as cheek puffing, tongue stretching, and dry swallowing practices. The second common issue is articulation disorder, for which we can teach patients some speech training. Usually, we can prepare patients with rhythm, cadence, and deep breathing exercises for speech training. The third is the dysfunction of limb mobility. For specific activities, we need to conduct training, including some balance function training.

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Written by Chen Yu Fei
Neurosurgery
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How does a brainstem hemorrhage clot get absorbed?

For patients with brainstem hemorrhage, edema generally enters the edema phase within 24 to 48 hours, and then gradually transitions into the absorption phase. During this period, it is first necessary to provide the patient with medications that enhance brain function, promote blood circulation and remove blood stasis, and nourish the nerves for treatment. At the same time, it is important to monitor changes in the patient's condition, and regularly perform a head CT scan to dynamically observe the changes in cerebral hematoma. In most cases, it is necessary to prevent various complications or concurrent diseases. If there is an abnormality in coagulation function, it is advisable to administer hemostatic drugs for treatment during the acute phase. However, once the patient's condition stabilizes, use medications that improve cerebral microcirculation and promote blood circulation and remove blood stasis for treatment.

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Written by Gao Yi Shen
Neurosurgery
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How long do you have to stay in the ICU for a brainstem hemorrhage?

The length of stay in the ICU for brainstem hemorrhage depends entirely on the patient's specific condition. Generally, as long as the patient's breathing is stable and they can breathe on their own, and all other vital signs are relatively stable, they can be transferred out of the ICU. However, this depends on the patient's condition at the time. Many patients are admitted to the ICU typically due to poor breathing and lack of autonomous respiration. If a ventilator is used and the results improve, they may then be transferred out. Some may be out in a week, while others may need one to two months. It is also crucial to determine whether they have developed ventilator-associated pneumonia, lower limb venous thrombosis, or other more severe clinical manifestations, so decisions should be made based on these conditions for accuracy.

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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 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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Neurosurgery
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Is a brainstem hemorrhage serious?

Brainstem hemorrhage is a type of cerebral hemorrhage, occurring within the brainstem, which is the central hub of human life. Thus, once a brainstem hemorrhage occurs, the condition becomes extremely complicated and severe, with very high mortality and disability rates. Clinically, brainstem hemorrhages of less than three milliliters have a mortality rate close to 70%. Those exceeding five milliliters have a mortality rate close to 90%, and hemorrhages over ten milliliters are invariably fatal. In recent years, there has been an increasing trend in brainstem hemorrhages, affecting younger populations. This is mainly due to high work stress, uncontrolled diet, lack of exercise, and notably, a lack of awareness and attention to hypertension among young people, which ultimately leads to brainstem hemorrhage. Brainstem hemorrhage is a very dangerous disease.