The overall treatment principles of brainstem hemorrhage are summarized in the following paragraph: early and rapid establishment of intravenous access, close multifunctional monitoring and oxygen inhalation, keeping the airway unobstructed, active and stable lowering of cranial pressure, timely adjustment of blood pressure to prevent continued bleeding, strengthening basic care and preventing complications. 1.Early establish two or more intravenous channels rapidly, and at the same time carry out close cranial vital signs monitoring, keep the airway unobstructed, and perform deep vein placement if necessary. In view of the site and characteristics of brainstem hemorrhage, most of the patients have early respiratory disorders, rhythm disorders, even airway obstruction and respiratory failure, immediately after admission, remove respiratory secretions and misabsorbed substances, keep the airway unobstructed, give low-flow oxygen, for patients with irregular respiration and rhythm disorders, immediately perform tracheal intubation and ventilator-assisted ventilation, for patients with airway obstruction and extreme respiratory difficulty, with the consent of family members For patients with airway obstruction and extreme respiratory distress, tracheotomy and ventilator-assisted ventilation were performed with the consent of the family. 2.Actively lower the intracranial pressure: lower the intracranial pressure, choose 20% mannitol 125ml or 250ml immediately after the onset, once every 8 hours. You can choose whether to perform emergency ventriculocentesis or lumbar pool drainage according to the emergency head CT results and the patient’s neurological examination of the pupils, and the ICU with conditions can perform intracranial pressure monitoring. Pay attention to the patient’s cardiopulmonary function and renal function changes, give active electrolyte supplementation, prevent water and electrolyte disorders, and monitor the patient’s in and out volume. Potassium supplementation is to pay attention to the patient’s urine volume, and fluid supplementation is to pay attention to the crystalloid ratio. If there is poor cardiac, pulmonary and renal function or the test index gradually becomes worse, it is appropriate to choose glycerol fructose 250ml intravenous input 2-4 times a day to lower the cranial pressure, while furosemide 20-40mg can be given according to the situation. glucocorticoids, such as dexamethasone 10-20mg 1-3 times a day, can reduce the cerebral vascular permeability and reduce cerebral edema in the early stage of the onset of cranial pressure. At the same time, glucocorticoids have a strong effect on scavenging oxygen free radicals, but it should be noted that they should be used with caution in hypertensive patients, diabetic patients and patients with ulcer disease. At the same time, diabetic patients should pay attention to monitoring blood sugar when inputting mannitol. 3. Adjust blood pressure to reduce the tendency to continue bleeding. Patients first dehydrated to lower cranial pressure, if the monitoring of blood pressure is still high and unstable, if the systolic blood pressure is greater than 200 mmHg, diastolic blood pressure is greater than 100 mmHg, the application of tachypnea, oral or tube feeding antihypertensive drugs for treatment. 4. Regarding the application of hemostatic drugs, most hemostatic drugs have poor effect on brainstem hemorrhage, but if the patient is admitted to the hospital with combined stress ulcer hemorrhage, hemostatic drugs can be considered when coagulation dysfunction exists. Patients are prone to stress ulcer hemorrhage at advanced age or in the acute stage, so apply H2-R antagonist immediately for prevention and treatment, and at the same time, if there is already bleeding, apply iced saline to flush the stomach and apply hemostatic drugs locally. 5.Strengthen nursing care: Patients with brainstem hemorrhage more commonly appear in deep coma, accompanied by tracheal intubation or tracheotomy, breathing and assisted ventilation. For ICU nursing put forward high requirements, prevention and control of upper gastrointestinal ulcer haemorrhage, early placement of gastric tube, if there is already bleeding care, give continuous gastrointestinal decompression, oral care, tracheotomy care is very important. It is also important to apply proper position, regular turning and back tapping, nebulized aspiration, airway care to prevent misaspiration and pulmonary infection. It is necessary to apply anti-decubitus air cushions and wear elastic stockings to prevent deep vein thrombosis in both lower limbs. The patient’s cranial vital signs and CVP should be closely monitored, while the patient should pay attention to the intake of enteral or parenteral nutrition and the addition of nitrogen to heat ratio and trace elements. Pay attention to the daily caloric and energy needs of the patient, and consider the application of neurotrophic agents such as GM-1, Brain-awakening, Qingkai Ling, Angong Niuhuang Pills, etc. for neurological rehabilitation as a treatment. 6, the treatment of central hyperthermia: primary brainstem injury due to cerebral hemorrhage can occur in about 6 hours after the onset of central hyperthermia, active physical cooling, including warm water bath, alcohol bath, ice bag cold compresses, electric ice blanket cooling, are necessary methods, but ice blanket cooling is a more effective measure, the cooling range can be controlled at about 32-35 degrees. At the same time, you can assist in drug cooling, such as no ice blanket can consider using the classic hibernation combination. 7, prevention and control of complications, brainstem hemorrhage patients have ventilator-assisted breathing, the presence of tracheal intubation or tracheotomy intubation, long-term can not be removed from the machine to remove the tube patients, prone to lung infection, the incidence is higher, followed by urinary tract infection, which is also an important cause of disease aggravation. Therefore, basic care is especially important. If there are abnormal blood leukocytes, we can consider giving broad-spectrum antibiotics for prevention and treatment, as well as monitoring patients’ blood changes, blood culture and drug sensitivity results for targeted medication. Monitor urine routine and culture results. Also pay attention to the long-term only antibiotics still appear high fever does not go away, there is the possibility of fungal infection, pay attention to the sputum, urine, stool related laboratory tests. 8, post-treatment: If the patient is awake, pay attention to the post-rehabilitation treatment, acupuncture, massage rehabilitation physiotherapy, etc. is very meaningful for the late recovery of patients. From mask oxygen to hyperbaric oxygen chamber treatment is also a means of recovery. At present, there are also related case reports: such as wake-up therapy, brain stem nerve stem cell transplantation, spinal cord electrical stimulation and other treatments for vegetative survival. However, these are only case reports. There is no bulk clinical data. We look forward to and follow it.