The brainstem is located directly above the spinal cord. It helps controls involuntary functions like heartbeat, breathing, and blood pressure. Nerves that are used for eye movement, hearing, talking, chewing, and swallowing are also controlled by the brainstem. Normal brainstem function is vital to survival.
A brainstem stroke happens when the brain’s blood supply is interrupted in this area. This type of stroke can result in death, since the damaged brainstem can no longer control the body’s vital functions.
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There are two main types of stroke: IschemicHemorrhagic
(the more common form) is caused by a sudden decrease in blood flow to a region of the brain, which may be due to:
A clot that forms in another part of the body (eg, heart or neck) breaking off and blocking flow in a blood vessel supplying the brain (embolus)A clot that forms in an artery that supplies blood to the brain (thrombus)A tear in a blood vessel supplying a part of the brain (arterial dissection)
is caused by a burst blood vessel that results in bleeding in the brain.
The symptoms of a brainstem stroke can be severe and may include: Problems with vital functions (eg, breathing)Difficulty with chewing, swallowing, and speakingWeakness or paralysis in the arms, legs, and/or faceProblems with sensationHearing lossVision problemsVertigo
(feeling of spinning or whirling when you are not moving)
“Locked-in syndrome” (only the eyes are able to move)Coma
If you or someone you are with has stroke symptoms, get emergency medical care right away.
Since this is an emergency, the doctor will make a diagnosis as quickly as possible. Tests may include: Exam of nervous systemComputed tomography (CT) scan
—a type of x-ray that uses a computer to make pictures of the brain
CT angiogram—a type of CT scan that evaluates the blood vessels in the brain and/or neckMagnetic resonance imaging (MRI)
—a test that uses magnetic waves to make pictures of the brain
Magnetic resonance angiography (MRA)
—a type of MRI scan that evaluates the blood vessels in the brain and/or neck
—a test that uses a catheter (tube) and x-ray machine to assess the heart and its blood supply
Heart function tests (eg,
—a test that uses sound waves to examine blood vessels
Blood testsTests to check the level of oxygen in the bloodKidney and liver function tests
Immediate treatment is needed to potentially: Dissolve a clot causing an ischemic stroke to allow blood flow to the brainStop the bleeding during a hemorrhagic stroke
The doctor and nurses will take steps to stabilize the functions of the heart and lungs. A tube may be placed into the windpipe to provide oxygen.
For an ischemic stroke, medicines may be given to: Dissolve clots and prevent new ones from formingThin bloodControl blood pressureTreat an irregular heart rateTreat high cholesterol
For a hemorrhagic stroke, the doctor may give medicines to: Work against any blood-thinning drugs you may regularly takeReduce how your brain reacts to bleedingControl blood pressure
These procedures may be done to treat an ischemic stroke: Embolectomy—a catheter is used to remove the clot or deliver clot-dissolving drugs
—carotid artery is widened and a mesh tube is placed to keep it open
For a hemorrhagic stroke, a clip or tiny coil may be placed on the aneurysm to stop it from bleeding.
Once your condition is stabilized, a feeding tube may be placed to deliver nutrients.
Brainstem strokes can lead to serious deficits. Therapy programs focus on regaining as much ability as possible: Physical therapy—to work on improving movementOccupational therapy—to assist in everyday tasks and self-careSpeech therapy—to improve swallowing and speech challengesPsychological therapy—to provide support in adjusting to life after the stroke
To help reduce your chance of having a stroke, take the following steps: Exercise regularly
that includes fruits, vegetables, whole grains, and fish.
Maintain a healthy weight.
only in moderation (1-2 drinks per day).
If you smoke,
If you have a chronic condition, like high blood pressure or diabetes, get proper treatment.
If recommended by your doctor, take a low-dose
If you are at risk for having a stroke, talk to your doctor about
Stroke (acute management): treatment overview. EBSCO DynaMed website. Available at:
. Updated April 11, 2011. Accessed April 15, 2011.
Last reviewed June 2012 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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