Brain stem is a vital part of brain situated in its posterior part. Almost half an inch in diameter, brain stem is made up of the medulla oblongata, pons and the mid-brain. Further down it continues with spinal cord. Brain stem is a main regulator of cardiac and respiratory functions besides being a carrier for sensory information. Blood pressure, breathing, alertness, heartbeats, digestion all are controlled by brain stem.
Being a control center of the brain, any damage to brain stem can seriously affect its function. Brain stem stroke occurs when blood flow to brain stem is impaired. Such type of stroke is caused due to burst artery in the brain (hemorrhage) or a blood clot (ischemia). Brain stem stroke is life threatening because it controls vital functions of the body such as breathing, and heartbeat. Early recognition and prompt treatment are thus important for recovery and good prognosis.
Causes And Risk Factors For Brain Stem Stroke
As mentioned earlier brain stem stroke can occur due to two factors, ischemia or hemorrhage. Ischemic stroke occurs when a blood clot from heart vessels or neck vessel blocks the blood flow to the brain stem. Formation of clot in the tiny artery of brain can also cause ischemic brain stem stroke.
Hemorrhagic brain stem stroke occurs when the blood vessel supplying blood to the brain stem burst causing severe bleeding in the brain tissue. Below are given certain triggering factors that may increase the risk of brain stem stroke:
- High blood pressure.
- Increased blood cholesterol.
- Irregular pumping of heart.
- Smoking and tobacco chewing.
- Diabetes
- Obesity
- Alcohol
- Drug abuse
- Sedentary lifestyle
- Diet high in salt
- Eating food having high fat content.
- Past history of stroke or cardiac illness.
- Taking oral contraceptive for long time.
- Increased tendency to bleeding or clotting.
- Certain metabolic syndromes.
- History of stroke in family.
Visible Symptoms Brain Stem Stroke
Person who experiences stroke in brain stem will show up with several symptoms. However, sometimes it is confusing because the symptoms can be confused for other conditions. Below are the main clinical features of brain stem stroke:
- Dizziness along with vertigo.
- Difficulty in breathing.
- Difficulty in speaking.
- Imbalance of body.
- Lack of co-ordination.
- Weakness in one side of body.
- Feeling lethargic all the time.
- Difficulty in chewing and swallowing food.
- Blurring of vision
- Hearing loss
- Slurred speech
- Loss of consciousness
- Coma
One of the most dangerous complications of brain stem stroke is lock-in syndrome. In this condition all the muscles of body are paralyzed, except for the muscles of eyes. Patient can only move his eyes sideways or blink his eyes.
Diagnosis And Treatment For Brain Stem Stroke
Brain stem stroke is a medical emergency. Prompt diagnosis and effective treatment is the essence of good prognosis in case of brain stem stroke. The emergency medical doctor will order MRI or CT scan. He will also recommend for electrocardiogram, Doppler study and 2 D echo depending on the severity. Certain blood tests are also recommended as the patient is admitted in the hospital.
Treatment is promptly started as the condition is critical and delay may lead to more complication. If the underlying cause is blood clot, patient will be put on clot dissolving medicines. The aim is to restore blood supply to the brain. There is good prognosis if the drug in given within 3 hours of stroke.
If the cause is hemorrhagic stroke, blood pressure medicines will be given orally or intravenously to reduce high blood pressure. Blood thinning medicines are never given in hemorrhagic strokes because it will increase bleeding. In case of aneurysm surgery may be required to stop bleeding.
Once the patient revives from the acute attack of brain stem stroke, after few days patient may need other therapies such as speech therapy, physiotherapy, and other physical rehabilitation measures for better living.