Symptoms of brainstem hemorrhage

Written by Gao Yi Shen
Neurosurgery
Updated on February 13, 2025
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The symptoms of brainstem hemorrhage can vary from mild to severe, depending on the specific presentation of the patient. For instance, in milder cases, symptoms may include simple headaches, dizziness, nausea, and vomiting without other clinical symptoms, which can often be easily distinguished from cervical spondylosis. Therefore, timely clinical examinations are necessary to confirm these conditions, which are generally mild and usually do not threaten life. However, symptoms might gradually worsen, manifesting as numbness in the limbs and speech impairments, among others. Some individuals may experience seizures, characterized by convulsions of the limbs, frothing at the mouth, etc. If the hemorrhage becomes more severe, it can compress more brainstem neurons, leading to coma, lethargy, and potentially severe outcomes like dilated pupils, and sudden cessation of breathing and circulation.

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How long is the period of brainstem hemorrhagic edema?

Brainstem hemorrhage, like hemorrhages in other parts of the brain, also has a period of cerebral edema. Cerebral edema is primarily caused by direct injury to brain tissue following hemorrhage, local ischemic and hypoxic changes, local metabolic products, and some damage to the vascular endothelium. Generally, the edema becomes apparent three days after the hemorrhage, peaks between three to seven days, begins to subside after ten days, and completely resolves around fourteen to fifteen days. However, there are exceptions, such as cases where edema occurs shortly after injury or within a few hours, and the peak period of edema lasts for several weeks, or even up to a month without complete resolution.

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Can brainstem hemorrhage be cured?

For brainstem hemorrhages that have already occurred, the patient should be immediately taken to a local hospital. Initially, a cranial CT scan should be performed to determine the location and amount of bleeding in the brainstem. For minor brainstem hemorrhages, it is recommended to first use medication for treatment. This involves administering drugs that stop bleeding, enhance brain function, promote dehydration, and nourish the nerves, aiding in the gradual cessation of bleeding and the absorption of cerebral hematomas. Most patients can achieve very good treatment outcomes. However, if the brainstem hemorrhage is extensive, it often leads to severe brainstem dysfunction and typically has a poor prognosis.

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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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How to rehabilitate from brainstem hemorrhage?

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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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.