Brain Stem Stroke: Symptoms & Treatment

Instructor: Adrianne Baron

Adrianne has taught high school and college biology and has a master's degree in cancer biology.

We are going to learn about brain stem strokes by discussing information about the signs and symptoms of a brain stem stroke as well as the treatments that are available.

Brain Stem Stroke

Have you heard the saying, 'It's all about location?' It was probably said in relation to where to live, but this saying applies in other areas of our life, as well. Location is definitely crucial when it comes to conditions that occur in the body.

Let's look at the blockage of an artery. If this occurs in the leg, it will cause some uncomfortable symptoms, but they aren't normally life-threatening and a patient can easily recover. That same blockage happening in the heart or brain is a totally different story. It's all about location! The blockage happening in different locations in the brain even causes different results.

The brain stem is the base of the brain
Diagram of the brain stem

The blockage of an artery in the brain stem can cause a serious condition to occur. The brain stem is the portion of the brain that sits at the base of the brain and leads to the spinal cord. It functions to relay messages for body movements and some very pertinent functions of the body that keep us alive such as breathing, heartbeat, consciousness, swallowing and blood pressure. If an artery in the brain stem is blocked, then there may be a loss of oxygenated blood supply to the brain stem which causes death and damage to brain stem tissue which we call a brain stem stroke.

Symptoms

A brain stem stroke causes symptoms that interfere with brain stem functions. This creates problems in those pertinent functions and movement.

One indication of a stroke in the brain stem is breathing problems. The brain stem may not be able to properly send signals to allow us to breathe. Breathing normally happens without us having to think about it. During a brain stem stroke, breaths may be skipped or too shallow.

The heartbeat will not be rhythmic like it is supposed to be. The heart may beat too fast or too slow or beats may be skipped altogether. This can be dangerous, since we don't have a way to manually make our own heart beat.

Difficulties with swallowing is another symptom seen with brain stem strokes. You may not be able to swallow or signals could be sent to swallow when you don't need or want to swallow. This is a bigger issue than you may think. It goes beyond eating and drinking problems. Swallowing closes off the windpipe, so not being able to properly swallow could cause you to choke or suffocate.

Eye movement may become more difficult due to a brain stem stroke. The eyes may become stuck in one position. Or they may partially move, but not go through the full range of movement. They may also not have coordinated movement so that they move in the same direction together.

A typical symptom of a brain stem stroke is balancing problems, known as vertigo. Your body orientation is determined by your ears and the signal is processed in the brain stem. Damage to the brain stem may cause your brain to think that your body is oriented in a way that it isn't oriented. This can cause dizziness and difficulties with standing or walking.

Your speech may also be affected by a brain stem stroke. There will likely be some kind of sounds coming out, but they may not create words. You will know what you want to say and how to say it, but the full signal to speak will not be relayed properly to every part of your face and throat that are needed to produce speech.

There are a set of rare, but possible symptoms, too. You may experience hallucinations and lose your sense of taste and smell. There is also the possibility of experiencing locked-in syndrome which is when you can think and do everything except move your body. The eyes are the only part of the body that you can move with locked-in syndrome.

Treatments

Now that we know what can go wrong with a brain stem stroke, let's see what we can do about it. Hopefully the blood supply to your brain stem will return quickly and nothing will have to be done to recover from the stroke. If you do need help then there are options available. The treatment will depend on the cause of the brain stem stroke.

Brain stem strokes caused by a blood clot will require something to dissolve the blood clot. Medications such as antiplatelet drugs will dissolve the blood clots and keep others from forming. Anticoagulants are another option to help prevent blood clot formation and keep current blood clots from getting any bigger.

There are also some invasive procedures to help get rid of the blood clot. A thrombolysis procedure is when the doctor attempts to manually break up the blood clot.

An embolectomy surgically removes the clot causing the stroke
Diagram of an embolectomy

An embolectomy is a surgery that can be done by inserting a catheter into the artery to remove the blood clot that is causing the blockage. The other possibility is making the opening of the artery wider by inserting a stent or balloon into the artery.

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