A brain stem stroke happens when the blood flow in the brain stem is disrupted. Because the brain stem is responsible for breathing, heart function, digestion, and alertness, this type of stroke can be dangerous. Early detection is a key factor in recovery and overall prognosis, so it is crucial to understand the symptoms and risk factors associated with brain stem stroke syndrome.
About Strokes in the Brain Stem
Strokes in the brain stem are caused by blood clots, arterial tears, or burst blood vessels, according to NYU’s Langone Medical Center. When the flow of blood to the brain stem stops or slows, the damaged stem can no longer function properly. Strokes in the brain stem are the most dangerous of all stroke types because they pose a danger to your body’s involuntary functions, including respiration and heartbeat.
Symptoms of a Brain Stem Stroke
Patients who experience a stroke in the brain stem will often show symptoms such as:
- Difficulty breathing
- Difficulty speaking
- Problems with chewing and swallowing
- Partial or complete hearing loss
- Blurred vision
- Weakness of the limbs
- Numbness or loss of sensation
Vertigo and dizziness are two of the most common brain stem stroke symptoms; in the case of a stroke in the brain stem, they usually occur together. Unlike other types of strokes, however, these two symptoms are not necessarily accompanied by a weak feeling on one side of the body.
Risk Factors for Brain Stem Stroke
Some people are more likely to experience a stroke in the brain stem due to factors related to current health and lifestyle. Health conditions like diabetes, elevated blood pressure, atrial fibrillation, and cardiovascular disease all place a patient at a higher risk. People with hemorrhaging or blood clots are more likely to experience a stroke. The NYU Langone Medical Center cautions that smoking, alcohol abuse, eating a high percentage of processed foods, a lack of physical activity, and drug abuse also lead to a higher risk of stroke.
Potential Stroke Complications
As with other types of strokes, strokes in the brain stem can cause complications in the body, including a loss of consciousness and impaired breathing. One of the most serious complications is locked-in syndrome, which is a paralysis of all of the muscles in the body except for the muscles that control the eyes. According to the Rehabilitation Institute of Chicago (RIC) LIFE Center, patients with locked-in syndrome often need a tracheostomy tube, a gastric tube, and a catheter to help with normal bodily functions. In most cases, doctors will establish a communication system with the patient that uses blinking or eye movement.
Diagnosing a Stroke in the Brain Stem
Time is of the essence when a stroke strikes, so emergency medical professionals will work quickly to make a diagnosis. Physicians will likely examine your nervous system response, test heart function, and check your blood oxygen levels. They may also put you through a computed tomography (CT) scan to check the blood vessels in your brain. Other potential diagnostic tests include magnetic resonance imaging (MRI) of the brain and neck. If a burst or torn blood vessel is suspected, the doctor may use a Doppler ultrasound to ensure that your vessels are intact. Brain stem stroke diagnosis is often difficult due to its complex symptoms, so your doctor may run a number of tests to validate any initial diagnosis.
Initial Stroke Treatment
When a stroke occurs as a result of a blood clot, the first step is to dissolve the clot to restore blood flow. Tissue plasminogen activator (tPA) drugs are particularly effective in dissolving blood clots when they are administered intravenously. To be effective, the drug must be given within three hours of the initial appearance of stroke symptoms.
When a stroke is caused by a burst blood vessel, doctors must first stop the internal bleeding. At that point, medical staff will ensure that your lung and heart functions are stable. Ongoing treatment will depend on the type of stroke experienced.
Treating Ischemic Strokes
Ischemic strokes of the brain stem, which are caused by blood clots or torn vessels, usually require medications to prevent future clots and thin the blood to make circulation easier and to break up any existing clots. Depending on the severity of the case, medicines may also be used for blood pressure, high cholesterol, and irregular heartbeats. According to the NYU Langone Medical Center, doctors may use a carotid endarterectomy to take out deposits of fat from your arteries. Other treatments include embolectomy for clot removal and carotid angioplasty for artery widening.
Treating Hemorrhagic Strokes in the Brain Stem
Hemorrhagic strokes in the brain stem, which are caused by burst blood vessels, require different medications than ischemic strokes. Your doctor may use medicines that prevent blood thinning and control your blood pressure. He may also use medicine to mitigate the effects of the bleeding in the brain stem. If you have an aneurysm, the NYU Langone Medical Center states that surgery may be required to stop the bleeding.
Recovering from a Stroke
The brain stem stroke recovery process is different for every patient; it depends on the severity of the stroke, the root cause, and the time that elapsed before treatment began. Patients may need to undergo therapy to regain their mobility, handle self-care, improve swallowing, and adjust to the psychological ramifications of a stroke. Dramatic recovery is possible, particularly when the patient experiences deficits in motor function rather than cognitive function. The best stroke rehabilitation centers in the US or best physical rehabilitation centers can often help you with a dramatic recovery. Someone who has experienced mild to moderate strokes in the brain stem often have mild vertigo and double vision after several weeks. Your diet is also important when recovering from a stroke. Check out our 50 Best Superfoods of 2015 which includes a list of foods that are great for healthy brain function.
Prognosis for Stroke Patients
The prognosis for stroke patients varies dramatically between individuals. The most important factor in a patient’s brain stem stroke prognosis is time. The sooner that you recognize the symptoms of the stroke and the sooner you get treatment, the better the prognosis is. If blood flow to the brain stem is regulated within a matter of hours, doctors have a broader range of treatments they can use, and patients have a better chance of experiencing full recovery. According to the University of Maryland Medical Center, the brain stem stroke survival rate is higher when the stroke is classified as ischemic.
Recovery & Prognosis for Patients with Locked-In Syndrome
Patients who suffer from locked-in syndrome as a result of a stroke in the brain stem have a different recovery process and prognosis. According to theRIC LIFE Center, patients need a great deal of assistance from family and medical professionals, often for the rest of their lives. After the onset of locked-in syndrome, patients generally must undergo:
- Bladder retraining
- Occupational therapy
- Speech therapy
- Physical Rehabilitation
Over time, many patients regain enough bladder function to allow the removal of the urinary catheter tube. Figuring out the cost stroke rehabilitation centers is important as it can be a very costly recovery depending on your insurance coverage. Others regain a small level of movement. In very rare cases, patients recover enough to walk and talk. The RIC LIFE Center states that most patients with locked-in syndrome have a life expectancy of ten or more years after a brain stem stroke.