How to rehabilitate from brainstem hemorrhage?

Written by Chen Yu Fei
Neurosurgery
Updated on February 27, 2025
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For patients with brainstem hemorrhage, it is often recommended during the acute phase to treat them with medications for hemostasis, brain enhancement, nerve nutrition, dehydration to reduce intracranial pressure, and inhibition of gastric acid. It is also important to actively treat complications and comorbidities caused by the brainstem hemorrhage. For these patients, when the condition is stable, appropriate rehabilitation exercises should be carried out. For patients with hemiplegia or aphasia, rehabilitation exercises can be done on the affected limbs, and speech rehabilitation training can help improve current conditions of hemiplegia and aphasia. Additionally, for these patients, active and passive massage of the limbs should be initiated early to prevent muscle atrophy and joint stiffness.

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Written by Gao Yi Shen
Neurosurgery
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How many milliliters of brainstem hemorrhage are fatal?

Brainstem hemorrhage does not have a specific volume that can be fatal; the brainstem is the central hub for respiration and circulation in the human body, including the medulla, midbrain, and pons. For the pons and midbrain, a hemorrhage of five milliliters can be fatal. For the medulla, which is very narrow and densely packed with neural tissue, even one milliliter of bleeding can suddenly cause the patient's respiration and circulation to stop. Therefore, even one milliliter of brainstem hemorrhage is an immeasurable loss, and brainstem hemorrhages should be classified as critically severe. Immediate hospitalization and treatment are crucial to achieve a relatively better prognosis.

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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 Jiang Fang Shuai
Neurosurgery
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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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Written by Zhang Hui
Neurology
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How is brainstem hemorrhage treated?

Brainstem hemorrhage is extremely dangerous and must be treated as soon as possible. The treatment plan mainly includes: the patient must rest in bed, avoid emotional stimulation, ensure smooth bowel movements, and must strengthen turning over and patting the back to prevent serious complications such as bedsores and pulmonary infections. In terms of medication, it mainly involves providing drugs that protect brain cells and nourish brain nerves. Additionally, because patients with brainstem hemorrhage have high intracranial pressure, it is necessary to administer dehydrating drugs to reduce intracranial pressure. Moreover, once the patient's vital signs stabilize, treatments such as acupuncture and rehabilitation training are needed to promote the recovery of neural functions. If the patient experiences respiratory failure, it is necessary to promptly use a ventilator for treatment. Furthermore, patients with brainstem hemorrhage who are bedridden for a long period can develop complications such as pulmonary infections and urinary system infections. If these complications occur, timely use of antibiotics is necessary to control the complications.

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Written by Jiang Fang Shuai
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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.