Brain Stem Stroke: Symptoms, Treatment, and Long-Term Outlook
What Is a Brain Stem Stroke?
A stroke occurs when blood supply to the brain is interrupted. The way a stroke affects the brain depends on which part of the brain suffers damage, and to what degree.
Sitting just above the spinal cord, the brain stem controls breathing, heartbeat, and blood pressure. It also controls speech, swallowing, hearing, and eye movements.
Impulses sent by other parts of the brain travel through the brain stem on their way to various body parts. We’re dependent on brain stem function for survival. A brain stem stroke threatens vital bodily functions, making it a life-threatening condition.
Two Types of Stroke
The most common type of stroke is an ischemic stroke, which is caused by a blood clot. A clot can form in an artery that supplies blood to the brain. A clot that forms elsewhere can travel through the blood vessels until it becomes trapped in a vessel that supplies the brain.
An arterial dissection is a tear in an artery that supplies blood to the brain.
The other type of stroke is called a hemorrhagic stroke, which is caused when a blood vessel bursts, causing blood to pool and pressure to build in the brain.
Common Symptoms of Stroke
Symptoms of stroke vary according to which area of the brain is affected. A stroke in the brain stem can interfere with vital functions like breathing and heartbeat. It affects other functions that we perform without thinking, such as eye movements and swallowing. It can impair speech and hearing or cause vertigo.
Signals from all over the brain move through the brain stem to reach other body parts. This is why some stroke patients experience numbness on one or both sides of the body, or paralysis of the arms or legs.
Rare Symptoms and Complications of Brain Stem Stroke
Brain stem stroke can cause you to lose your sense of smell and taste.
According to Stroke Association (U.K.), about one percent of stroke patients experience psychosis in the form of hallucinations (seeing or hearing something that isn’t there) or delusions (strong belief in something that’s not true).
Other rare complications include coma and locked-in syndrome. Locked-in syndrome is a condition in which the entire body, except for the eye muscles, is paralyzed. Patients are able to think and communicate through eye movements, such as blinking.
Who Is Likely to Have a Stroke?
Anybody can have a stroke, but risk increases with age. A family history of stroke or a mini-stroke (transient ischemic attack) increases risk. According to the Office on Women's Health, people over age 65 account for two-thirds of all strokes.
Males and people of African-American, Hispanic, or Asian/Pacific Islander descent are at higher risk, according to NYU Langone Medical Center. Women are more likely to die from stroke than men are.
High blood pressure, high cholesterol, diabetes, cardiovascular disease, and certain blood disorders increase the risk of stroke. So do pregnancy, cancer, and some autoimmune diseases.
Lifestyle Risk Factors
While some factors that increase your stroke risk are beyond your control, some lifestyle choices can increase your likelihood of suffering a stroke. These include long-term hormone replacement therapy and the use of birth control pills, particularly in women over the age of 35 who also smoke.
Other behaviors that increase risk of stroke include:
- physical inactivity
- alcohol abuse
- drug use (such as cocaine, heroin, and amphetamines)
How Is Stroke Diagnosed?
A brain stem stroke is a life-threatening medical emergency. If you have symptoms that indicate stroke, the emergency medical team is likely to order imaging tests such as MRI scan, CT scan, Doppler ultrasound, or angiogram. Heart function testing may include electrocardiogram and echocardiogram. Additional diagnostic procedures may include blood tests, as well as kidney and liver function testing.
In the event of ischemic stroke, the first line of treatment is to dissolve or remove the blood clot. A catheter can be used to remove the clot in a procedure called an embolectomy. Or, it can help administer clot-busting medications. In some cases, angioplasty and stenting are used to widen an artery and keep it open.
For a hemorrhagic stroke, the bleeding must be stopped. A clip or coil is sometimes placed on the aneurysm to stop the bleeding. Medication to reduce clotting also may be required.
In the meantime, your medical team may need to take additional measures to keep your heart and lungs functioning.
A brain stem stroke can result in serious long-term problems. Medication and ongoing therapy may be necessary. Physical therapy can help patients regain large motor skills and occupational therapy can help with everyday tasks. Speech therapy can help you regain control over swallowing and improve speech.
Some survivors of brain stem stroke are left with severe disabilities. In these casdes, psychological counseling can help them adjust.
Despite the risks that you can’t avoid, there are some things you can do to decrease your chances of stroke. Some general guidelines to follow include:
- Eat a low-fat and low-sodium diet rich in fruits, vegetables, and fish.
- Exercise regularly.
- Don’t smoke.
- Don’t abuse alcohol or drugs.
If you’re obese or have high blood pressure, diabetes, or a type of chronic illness, follow your doctor’s recommendations for keeping them under control.
- Anatomy of the brain. (n.d.). University Hospital New Jersey Stoke Center. Retrieved January 7, 2014 from http://www.uhnj.org/stroke/anatomy.htm
- Brainstem stroke. (2013, November). NYU Langone Medical Center, Department of Medicine. Retrieved January 7, 2014 from http://medicine.med.nyu.edu/conditions-we-treat/conditions/brainstem-stroke
- Rare effects of stroke. (2012, November). Stroke Association U.K. Retrieved January 7, 2014 from http://www.stroke.org.uk/sites/default/files/Rare effects of stroke_0.pdf
- Stroke fact sheet. (2012, July 16). Office on Women’s Health, U.S. Department of Health and Human Services. Retrieved January 7, 2014 from http://womenshealth.gov/publications/our-publications/fact-sheet/stroke.html