Shanghai, July 3 – A 37-year-old hypertensive patient, Zhang Lei (pseudonym), suffered a 15ml brainstem hemorrhage, leaving his life hanging by a thread. Shanghai specialists performed a precise surgery to remove the hematoma, maximizing the protection of nerve fibers. After a month of treatment, a miracle occurred: Zhang regained fluent speech, the ability to eat independently, restored limb muscle strength to near-normal levels (grade 4), and full control over urination and defecation. This outcome defied the typical medical prognosis that “a 15ml brainstem hemorrhage usually results in death or severe disability.”
The brainstem, composed of the medulla oblongata, pons, and midbrain, is often referred to as the body’s “life command center.” Due to its central location, even a small hemorrhage (<5ml) can cause facial paralysis or double vision, with the risk of respiratory arrest from swelling. A moderate hemorrhage (5ml–10ml) is considered high-risk, leading to confusion and difficulty swallowing, often requiring ventilator support. When bleeding exceeds 10ml, mortality rates soar to 70%–90%, with survivors often left in a vegetative state.
“In medical terms, a brainstem hemorrhage exceeding 10ml is almost equivalent to a ‘death sentence,'” explained a specialist from Shanghai Donglei Brain Hospital. “Our goal was clear: remove the hematoma and relieve pressure on the brainstem.”
Brainstem surgery has long been considered a no-go zone in neurosurgery. Every millimeter of surgical advancement carries catastrophic risks—respiratory failure, permanent paralysis, or a vegetative state. Operating here is like “defusing a bomb on a tightrope.”
The medical team chose a dorsal medullary velum approach, entering the hematoma cavity from the closest point to minimize damage. “The hematoma was deeply embedded within the brainstem, surrounded by critical neural ‘high-voltage lines.’ Traditional approaches risk crossing vital functional areas, increasing the chance of secondary injury,” the specialist noted. “For brainstem hemorrhages, we follow safe surgical pathways, targeting the nearest accessible point to the hematoma to minimize trauma.”
“We determined Zhang’s hemorrhage was caused by uncontrolled hypertension. Long-term irregular blood pressure weakens arterial walls, reducing elasticity and forming microaneurysms in small vessels. Under high pressure, these vessels can rupture,” the specialist added.
Zhang admitted to having hypertension for six months but only took medication intermittently and rarely monitored his blood pressure. “Uncontrolled hypertension turns blood vessels into ‘brittle pipes,’ making them prone to rupture under sudden pressure spikes. Consistent medication is crucial for hypertensive patients!” the specialist emphasized.
With modern diets high in sugar, salt, and fat, coupled with irregular lifestyles (late nights, smoking, alcohol) and increased stress, more young people are developing hypertension. Experts stress that diagnosed patients must take medication regularly, never adjust doses without supervision, monitor blood pressure daily, avoid emotional extremes (especially sudden rage), and refrain from breath-holding or straining. High-risk individuals (long-term smokers/alcoholics, those with a family history of cerebrovascular disease) should undergo annual brain MRI and vascular imaging (MRA) to detect hidden stroke risks (aneurysms, arterial narrowing, etc.).
