CASE REPORT article
Front. Neurosci.
Sec. Translational Neuroscience
Multimodal management of a large-volume brainstem hemorrhage with stereotactic drainage, targeted antimicrobial therapy, and early neurorehabilitation: a case report
Provisionally accepted
- Shaanxi Provincial Rehabilitation Hospital, Neurological Rehabilitation Department, Xi'an, China
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Moderate-volume brainstem hemorrhage (>5mL) typically carries an extremely poor prognosis. This article presents a rare case of survival following a large-volume brainstem hemorrhage with therapeutic intervention. A 47-year-old male with hypertension presented with sudden-onset coma. CT imaging revealed a 10.3mL brainstem hemorrhage. The patient underwent hematoma puncture drainage and tracheostomy, accompanied by hemostatic therapy, intracranial pressure reduction, anti-infection treatment, and neurorehabilitation. During treatment, the patient developed recurrent multidrug-resistant bacterial infections. After two months, the patient gradually regained consciousness with improved limb muscle strength, though exhibiting motor aphasia, dysphagia, and urinary/fecal incontinence. Rehabilitation therapy was continued. This case demonstrates that even with large-volume brainstem hemorrhage, comprehensive management including timely drainage, intracranial pressure control, tracheostomy, infection management, and early rehabilitation may achieve survival and consciousness recovery. However, as a single-case report, this study has limited sample size, necessitating further large-scale randomized controlled trials to validate these findings.
Keywords: Brainstem hemorrhage, case report, Hematoma puncture drainage, Multidrug-Resistant Organisms infection, Neurorehabilitation
Received: 07 Oct 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Han, Huang, Ning and Shang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenhui Shang, 1158487937@qq.com
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