After bleeding from the brainstem cavernous hemangioma, is the symptom "self-healing" when the symptoms improve?

Have you grasped the initiative to see a doctor?

After the first bleeding of the brainstem cavernous hemangioma, does the improvement of symptoms mean "self-healing"? Do you know the crisis of bleeding again? The improvement of symptoms of brainstem cavernous hemangioma can only indicate that the acute stage of bleeding has passed, but it does not mean that it has healed itself! After the acute stage, hemosiderosin precipitation will form, which cannot be absorbed by itself, just like rust water, it will stimulate peripheral nerves for a long time, causing chronic chemical damage
.
The longer the time, the greater the damage and the less
likely it is that surgical repair will be.

The history of most patients suggests that bleeding is not "one-time" and tends to occur
irregularly.
As the number of bleeding increases, there is often a tendency to increase the frequency of rebleeding, worsen symptoms, and even become irreversible damage
.
If bleeding affects the nucleus of the facial nerve, facial paralysis can occur; If sensory and motor nerve tracts are affected, numbness and weakness in the limb can result
.
The size of the brainstem is like a human thumb, and repeated bleeding several times may cause the entire brainstem to be flattened and infiltrate
.

Patients often ask, is rebleeding predictable? The answer is no
.
"Time bomb" is the unified name of many patients with brainstem cavernous hemangiomas and vascular malformations for the lesions, because the lesions are like time bombs, do not know when to detonate, may be in sports, may be in emotional ups and downs, even staying up late and tired, or may not have any signs and triggers
.
Walking, sleeping, driving and other daily life or sudden outbreak of bleeding, once the brainstem hemorrhage is large, it is difficult to rescue, light to cause irreversible damage to sports, language and other functions, the worst is direct death
.
This bleeding can sometimes be repeated a second or third time, and may be worse
each time.
Therefore, patients with cavernous hemangioma of the brain, especially patients with brainstem cavernous hemangioma once bleeding, live in fear every day, sleep hard, and even lead to depression, which will seriously affect normal life
.

Therefore, every patient should have the initiative to see a doctor, and when you still have the opportunity to choose, you can choose the best
.
Once there is a passive situation, the opportunity you want to choose is gone, you can only accept the options you can choose, even the judgment of death! Even if the symptoms are relieved after the first bleeding, you should consult a suitable doctor in time to fully assess the condition and the risk of rebleeding, determine whether surgical resection is required and the best time for surgery
, and strive for the best cure for yourself.

He had a brainstem tumor and was never able to operate for 6 months

What did he do when the tumor disappeared and he returned to the workplace?

One day six months ago, 25-year-old new media blogger Haochen (pseudonym) was working on an idea
.
Suddenly, a slight numbness hit his right hand and foot, and he thought it was just pressed
.
I didn't expect to suddenly have ringing in the left side of the ear two days later, and there would be discomfort when the outside sound was loud
.
This was followed by dizziness and double vision
after a nap.

Out of instinct, Haochen decided to go to the hospital for a check-up
.
The results of the examination surprised him: he found that his left eye could not be abducted, CT examination showed bleeding in the left brainstem, and the doctor diagnosed it as "brainstem cavernous hemangioma" with hemorrhage, which caused him to have the above symptoms
.

Haochen couldn't believe it: "I insist on exercising every day, and I usually don't even have a cold, how did I suddenly become a brain tumor?" ”

The doctor took the light film and said with an indifferent expression: "In a situation like yours, we can't operate, so it is recommended to go home to rest and observe conservative treatment.
.
.
"

However, only 6 months later, Haochen has successfully operated on it, and the "brainstem lesion" in his brain has been completely removed
.
And, now back to work and work!

How did Haochen successfully operate when the doctors told him that the brainstem position was inoperable?

Outstanding young man, smooth sailing, deeply shocked after being diagnosed with a brain tumor

Haochen has been a good baby in the eyes of his parents since he was a child, a good student in the eyes of teachers, excellent grades, and very handsome looks
.
After graduating from a well-known university, he started a business directly and became a new media blogger
.
Growing up in a happy and warm family, he is self-motivated, optimistic and positive, and his work and life have always been very smooth, which is enviable
.
No matter how busy he is, Haochen will find time to exercise
.
Running, swimming, skiing, climbing.
.
.
Haochen also likes a lot
of sports.
After active exercise, Haochen's body has been very good
.

But cancer is like a demon, quietly eyeing Haochen
.
When the above series of symptoms could not be relieved, his parents accompanied Haochen to the hospital for examination
.
The doctor looked at Haochen's CT scan and said: "You are a cavernous hemangioma of the brainstem with hemorrhage, it is recommended to go home to rest and conservative treatment and observation
.
" ”

Parents can't believe it, how can a good person suddenly get a brain tumor?

On the second day, Haochen did MRI and CTA tests
accompanied by his parents.
They hoped that the test results were wrong, not Haochen's body
.

Unfortunately, all the test results are the same
.
Even Haochen also had facial paralysis, unable to make expressions, and his whole face was symmetrical when expressionless.
.
.

At first, the family was a little unacceptable, especially Haochen himself, and was deeply shocked
.
He didn't understand why he had a brain tumor after living so actively and hard? Is it so hard that this is an unfair life?

However, Haochen does not believe in fate, life is so beautiful, how can he give up easily! After a short period of despair, the spirit of never giving up and having the courage to face everything in Haochen's bones returned
.

Calm down, bent on finding how to solve this problem, and then look up various professional authoritative materials on the Internet, he knows that his fate is in his own hands, or he has to rely on himself to find a solution
.

It is also unacceptable for Haochen's parents, especially for the mother, such an excellent son, finally the child grows up, and the work is very smooth
.
However, at this stage of going up, it suddenly stopped, which was really unacceptable
.
The mother was anxious and couldn't sleep every day, her hair was much grayer for a while, and she had no energy
every day.
Every time I think of the doctor saying that it is impossible to operate, I feel a deep fear
of this brain tumor "demon".
But for the treatment of children, the family is always standing together, and they are willing to do everything for the sake of the child.
.
.

The whole family started the road to fight brain tumors, there were hesitations, but in the end they still had the same goal!

In the initial period after the diagnosis of cancer, Haochen accompanied by his parents, went around to search for famous doctors and seek treatment
.
However, the results were "mostly recommended conservative treatment, with surgery
considered after secondary bleeding.
" ”

When they found the professor, the whole family was very unanimous: they wanted the best treatment so that the child would not have any sequelae after the operation! With such a belief, it undoubtedly gave the Haochen family new hope
.

But due to the epidemic, Haochen could not go to the hospital in time for re-examination, and the family was also very anxious, and then in the process of slowly resting at home, Haochen's symptoms slowly improved, and the family was also very happy
.
When the re-examination was carried out, the bleeding was also absorbed, but the lesion remained
.

The bleeding is absorbed, the symptoms are relieved, then do you need surgery? Haochen's parents, like many patients with brainstem cavernous hemangioma who have experienced bleeding, began to hesitate a little, because they felt that the symptoms might gradually improve, and the lesions could disappear directly on their own, and whether surgery was not needed
.
And if the surgery goes bad, the symptoms worsen or other conditions appear, they will definitely not be able to accept it
.

Although there was hesitation, the family decided to consult the professor before deciding on the next treatment plan, they wanted to hear the opinions of the world's neurosurgery masters.
.
.

"With clear indications for surgery, I can operate on this patient"

The professor's reply was very optimistic, and he also suggested that although the operation was elective, it might be better if he did it early
.
Based on the history and imaging data, the diagnosis is indeed hemorrhagic cavernous vascular malformation (cavernous hemangioma).

"Among my patients, I always try to completely remove the lesion (100% resection), and I can achieve this goal of total tumor resection in about 99% of previous patients
.
"

Screenshot of Professor Ba's email reply

Conservative treatment is always possible because the patient's condition does not deteriorate
.
However, there is a risk of rebleeding in the future, and we do not know or can not accurately predict the severity
of the next bleeding.
Since the lesion can be successfully reached by surgery, microsurgical resection is a good treatment option because it eliminates the risk of
lesions and further bleeding.
No other treatment is required after surgery, and patients can return to work
approximately 2 months after surgery.

After getting Professor Ba's accurate answer, they no longer hesitated and began to prepare, wanting to do this surgery as soon as possible in a short time, because the sooner it is done, the better, and then those blood clots that bleed can be removed
.
The parents loved their children, and they went to Germany
as soon as possible with the assistance of INC staff.

The German operation was successful, even better than the professor assessed!

Together with his father, Haochen started the road
of treatment in Germany.
Although the mother is in China, all her thoughts are her precious son, she is worried about anxiety, sleep is difficult, and every time she wakes up from nightmares.
.
.

After the operation, the results were better than the professor's assessment, the symptoms did not worsen, and then there were no new symptoms, and Haochen's parents were very happy
.
Then at that time, Haoran's mother also wrote a letter of thanks, and she was very moved to see it, and then she also said that if she would encounter such patients in the future, she would also encourage them from her own case, find the best doctor for surgery, and don't miss the best treatment time.
.
.

Since returning to China, about 3 months, Haochen has now gone to work normally, although some of the symptoms before surgery have not been completely relieved, but the professor said during the follow-up visit that the only thing Haochen needs now is time, the symptoms are not particularly serious, you don't have to worry
about it.
After receiving a reply from the professor, Haochen continued to live
the way he liked.
Exercise, travel, study, work hard, get back to that sunny and handsome guy.
.
.

This is lucky Haochen, after experiencing the first bleeding, active treatment and success.
.
.
However, there are also some patients with brainstem cavernous hemangioma who fell directly into a coma without knowing anything because of sudden brainstem hemorrhage, and lost their lives
forever for just one week.

Statements from family members of patients with brainstem cavernous hemangiomas

Brainstem hemorrhage to death, what happened in the last 7 days?

At 3 pm on the 18th, his wife suddenly suffered a brainstem hemorrhage of about 5ml, which caused a brainstem cavernous hemangioma
.
Everything happened so suddenly, without knowing anything, the wife was already in a coma and could not speak .
.
.

Hope remains, and I want to believe in miracles

20th - Hope for miracles
.
Today the situation is quite stable, the heartbeat is not steady, and the breathing seems to be improving
.
But because of the heartbeat problem, I was afraid that you would be at risk, and I never dared to sleep
.

21st - The doctor said that the situation is not too stable, breathing is worse than yesterday, the heartbeat is unstable, the risk is too great, tomorrow depending on the situation and then say whether to do surgery
or not.
You must hold on!

There are 2 hours to go and the bleeding is 72 hours
.
I have been in the hospital for 3 days and 3 nights, and now 72 to 120 hours is the peak of edema, I must have persevered! The child is too young to give up, I know you are sad and painful now, but you must hold on!! Although I am still in a coma, I can't hear, see, or speak, but I firmly believe that you will hold on! I'll be with you
no matter what.

22nd - I woke up at 3:30 o'clock in the middle of the night today, and I couldn't sleep
.
After listening to the doctor's advice in the morning, there was not much change in general, and the blood pressure fluctuated greatly, but this is a good phenomenon
.
At this time, if you are not afraid of high, you are afraid of low, and it is a good phenomenon to be high! Other breathing, heartbeat, and body temperature can be stabilized, and it will be 96 hours until 4 pm today, 4 days and 4
nights.
If you insist on it, maybe there will be a little improvement, but no, if you can stabilize, it is a victory!

Number 23 - You still don't breathe very well today, don't be in a hurry, just hold it steady! Then today the doctor will see, how to stabilize how to come! I believe you will survive! Come on! I will have a CT tomorrow, and the bleeding has been 5 days and 5 nights now
.
You will definitely survive!! These days are estimated to be the peak of edema, and may also be the most dangerous time
.
Hold on, tomorrow must be safe!

Pessimism: decreased blood pressure, increased bleeding, and continued deterioration

24th - Do CT today, the doctor said that you are not doing well, your blood pressure is low
.
After doing a CT and coming out, you are bleeding more than before
.
The doctor said that it was not very good, to be honest, I was quite shocked, but in addition to the bleeding more, it means that you have been insisting that your foundation is good and will definitely survive!

On the 7th day of the brainstem hemorrhage, you have also suffered so much in these 7 days, suffering you, will it get better, right? No more serious development? There will be miracles, right? I remember it was the day after I came to the hospital, and I heard you call me and call me three times
.
If you have anything to say, tell me in your dreams, I will help you handle it in this life and this life, and I will accompany you
in the next life.

On the 25th, I just listened to the doctor's advice and said that you are leaving, and it is possible
at any time.
There was already too much bleeding, and in the end, you finally went .
.
.

Real case sharing from well-known domestic forums

"Brainstem hemorrhage" that makes people "talk about color change"!

If the brain is the headquarters of the whole body, then the brain stem is the commander-in-chief of the headquarters
.
Brainstem is known as the "forbidden area of life", in which the nuclei of cranial nerves and the upper and lower conduction tracts connecting limbs with the brain are densely arranged, and its main functional divisions: cardiovascular center and respiratory center; Maintain our awake brainstem ascending activation system; At the same time, it is the necessary way for the brain to communicate with the spinal cord, including the sensation and movement of the limbs
.
Once damaged, the consequences are unimaginable
.

Is brainstem cavernous hemangiomas more likely to bleed twice?

The first bleeding rate of brainstem cavernous hemangiomas is only 0.
6% to 1.
1%, while the recurrence rate can be as high as 30% to 60%.

The first bleeding is a wake-up call for the patient, after which the bleeding interval will be shorter and shorter, often each bleeding, accompanied by the progressive aggravation of symptoms, the possibility of recovery of neurological symptoms is extremely low, the risk will be higher and higher, when the amount of bleeding reaches 10ml, the mortality rate is nearly 100
%.

How does brainstem cavernous hemangiomas prevent rebleeding?

Because recurrent bleeding is an important cause
of disability and death in patients with brainstem cavernous hemangioma.
Rebleeding is more likely in cases of partial resection, which can cause catastrophic neurological deficits, so total resection of the lesion (BSCM) is the fundamental way to prevent rebleeding and cure the patient
.
In recent years, with the advancement of neuroimaging, the application of neuronavigation, neuroelectrophysiological monitoring, and the advancement of microneurosurgery technology, the effect of total resection surgery has also improved
significantly.

In 1928, Dandy completed the first case of brainstem cavernous hemangioma surgery, with the rapid development of neuroscience, surgical treatment of brainstem cavernous hemangioma research reports are also emerging, foreign total resection technology is relatively mature, and has achieved significant treatment results
.

In a foreign data report of 137 patients with brainstem cavernous hemangioma, 97% of patients said that they returned to normal life and work
.
In addition, it has also been reported that in the comparison between the total resection treatment group and the conservative treatment group, the mortality rate of the conservative treatment group is significantly higher than that of the total resection treatment group
.
Therefore, through the following figure 2012-2014 foreign total resection effect statistics, it can be seen that for patients who are eligible for surgery, total resection surgery has the following advantages:

1.
It can effectively improve the long-term prognosis of patients and return to normal life
.

2.
It can effectively remove the tumor body, so that there is basically no difference
between nerve function and preoperative operation.

3.
It can intuitively change preoperative neurological disorders without other sequelae
.
Preoperative neurological problems also mostly improved
.

4.
It can achieve extremely low surgical trauma area and reduce the postoperative bleeding rate
by microsurgical technology.

5.
It can reduce the mortality rate of surgery to a very low level, and there is basically no surgical risk

In the past decade, although with the continuous understanding of the natural history of brainstem cavernous hemangioma, microanatomy, neuroimaging, navigation and intraoperative electrophysiological monitoring technology, surgical technology, surgical instruments, brainstem this surgical "forbidden area" is gradually being crossed and breakthrough, surgery has become the preferred treatment strategy for brainstem cavernous hemangioma, but at present this is still very challenging for doctors, only a few neurosurgical experts can truly achieve safe and complete surgical relapse curative
。

The first bleeding rate of brainstem cavernous hemangiomas is only 0.
6% to 1.
1%, while the rebleeding rate can be as high as 30% to 60%; And for each bleeding, the interval between rebleeding is shortened; With each bleeding session, the patient's symptoms worsen progressively, and neurologic symptoms are less
likely to recover.
However, the brainstem has long been regarded as a "surgical no-go zone", and even with the development of microneurosurgical techniques, intraoperative assistive techniques, and the discovery of brainstem safety zones, only a few surgeons have reported
more successful surgeries.
Based on his experience in more than 300 surgical cases, Professor INC Ba summarized the key points of surgical treatment experience of brainstem cavernous hemangioma as follows:

1.
Severe clinical symptoms indicate indications for surgery;

2.
Incidentally discovered (static, no clinical manifestations, no bleeding) cavernous hemangioma temporarily does not require surgical treatment;

3.
In patients with rapid progression and deterioration, emergency surgery to remove the tumor is beneficial, which is equivalent to rescue surgery;

4.
There are many surgical approaches that can be chosen, but the shortest surgical path to the tumor is not necessarily the best surgical approach; Some longer approaches are good for functional protection in specific situations;

5.
According to the patients operated by Professor Ba, more than 90% of patients can achieve good or excellent prognosis;

6.
Patients with re-bleeding should be operated again
.

Summary of the experience of surgical treatment of brainstem cavernous hemangioma by Professor Ba: 【2022 International Extratheological Master Course】Professor Bartlon Feld, Germany, 309 cases of brainstem cavernous hemangioma surgery and analysis of their results