The main causes of brainstem hemorrhage are as follows: First, hypertension. Long-term hypertension can lead to sclerosis of small intracranial arteries and vitreous changes in blood vessels, making them more brittle, which can easily lead to bleeding of small arteries in the brainstem when blood pressure rises and emotions are excited. Second, cavernous hemangioma, arteriovenous malformation, etc. The most common vascular malformation for brainstem hemorrhage is cavernous hemangioma. Because of the thin wall of small blood vessels in the hemangioma, the blood vessels are prone to bleeding when blood pressure rises, causing brainstem hemorrhage. Thirdly, tumor necrosis with hemorrhage in brainstem, tumor in brainstem is usually malignant tumor, glioma, tumor growth rate is faster, easy to complicate the necrosis of tumor center point, ischemia and tumor stroke, thus causing brainstem hemorrhage.