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Brain Stem Damage: Symptoms, Treatments, and Recovery

management and treatment for brain stem damage

Of all the various types of brain injuries, brain stem damage is by far the most life-threatening.

Although these injuries are often devastating, it is still possible for a person with a brain stem injury to recover.

Here’s everything you need to know about brain stem damage, including the steps you must take to recover.

What Is the Brain Stem?

brain anatomy showing location of brain stem damage

Located at the base of the skull, directly above the spinal cord, the brain stem is perhaps the most pivotal region of the entire brain. It is responsible for all the functions that keep you alive and aware of your surroundings.

The brain stem comprises three distinct sections:

  • Midbrain. At the top of the brain stem rests the midbrain. This structure plays a large role in muscle movement, particularly eye movement.
  • Pons. Below the midbrain lies the pons. The pons acts as a bridge between the cerebellum and the spinal cord and helps you control your balance, among other things.
  • Medulla. Finally, at the bottom of the brain stem is the medulla.

The medulla is in charge of essential life functions, such as:

  • Breathing
  • Heart rate
  • Swallowing
  • Blood pressure

Severity of Brain Stem Damage

Not only does the brain stem control vital bodily functions, but it’s also the link between the spinal cord and the rest of the brain.

All the other brain regions send information through the brain stem before heading out to the rest of the body.

This means that brain stem damage can impair many other functions besides the ones the brain stem has direct control over.

In fact, if no signals can pass through the brain stem into the spinal cord, the person could become effectively paralyzed.

Fortunately, brain stem damage is rare because the brain stem is difficult to damage directly.

Instead, most brain stem injuries are a result of swelling from other injuries. This swelling pushes the brain stem against the skull and causes damage.

You can also damage your brain stem if you suffer a diffuse axonal injury that shears the axons in the pons or medulla.

Symptoms of Brain Stem Damage

Brain stem injuries cause serious problems and require intensive treatment. Below are some of the most common symptoms of brain stem damage.


man in deep coma from brain stem damage

The brain stem houses a network of neurons called the reticular activating system, which helps a person wake up from sleep.

When the brain stem becomes damaged or swollen, this system gets compressed, causing the patient to fall into a coma.

Most comas will fade once the swelling goes down. After that, a person will usually pass through the last three disorders of consciousness before finally waking up.

Locked-In Syndrome

Sometimes, however, after the person wakes up from their coma, the brain stem is so damaged that they cannot move anything but their eyes. Doctors call this condition locked-in syndrome.

When a patient has locked-in syndrome, they possess normal intelligence and reasoning skills and can hear everything going on around them. They just cannot communicate.

They are, quite literally, locked into their bodies like a prison.

There is no treatment for locked-in syndrome, and most people with this disorder do not regain movement, though some have.

Instead, supportive care is the best option for these patients. There are also computer programs that track eye movement and help the person speak artificially.

Swallowing Problems

old man with swallowing problems talking to doctor after brain stem damage

Not all brain stem injuries lead to coma or paralysis.

Instead, some can cause swallowing problems, such as dysphagia.

While the brain stem is not the only part of the brain in charge of swallowing, it plays a significant role in automatic swallowing and the gag reflex. This means that people with brain stem injuries are at a greater risk of choking on their own saliva.

Luckily, you can treat most swallowing problems with swallowing exercises for dysphagia. A speech therapist is the best person to teach you these.

Respiratory Problems

The medulla controls your breathing by sensing the level of carbon dioxide in the blood and adjusting your respiratory rate in response.

If the medulla becomes damaged though, it can’t sense how much CO2 is in the blood. As a result, it doesn’t know how much air the body still needs. That’s when breathing problems can arise.

The most common respiratory problems after brain stem damage include:

  • Hyperventilation: Breathing too much too fast
  • Hypoventilation: Breathing too little too slow
  • Apneustic breathing: Problems exhaling air
  • Apnea: Lack of breathing

Sensory Problems

Problems with sensation and balance can also affect people with brain stem damage.

That’s because, as we mentioned above, the brain stem serves as a bridge between the spinal cord and the rest of the brain.

If this bridge is broken, then the body cannot receive messages from the brain. As a result, you can experience numbness and muscle weakness.

Treatment for Brain Stem Damage

Close up of doctor holding patient's hand

To treat brain stem damage, you must address the symptoms.

If you struggle with muscle weakness, physical therapy exercises will help you regain strength.

You just have to make sure you do enough exercises to trigger neuroplasticity, your brain’s natural healing mechanism.

Because of neuroplasticity, your brain can form new neural pathways. These pathways allow undamaged portions of the brain to take over functions controlled by damaged ones. It does this in response to repetition.

Therefore, the more you practice an action, the more you will reinforce those neural pathways. And the stronger those pathways are, the easier the activity will become!

This principle applies to every type of brain damage, even brain stem damage.

Brain Stem Damage: Conclusion

Without a doubt, brain stem injuries are much more debilitating than other injuries. However, even with brain stem damage, it is still possible to improve skills such as swallowing or breathing.

There’s no such thing as a hopeless case. As several severe brain injury recovery stories show, the brain is a remarkably flexible organ, and with the right treatment and enough perseverance, you might just surprise yourself by how much you can recover.

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Get Inspired with This TBI Recovery Story

Independance, motivation and hope!

“My son Sharat suffered a severe traumatic brain injury 23 years ago leaving him with Aphasia and right sided weakness from his vision,hearing to his limbs. The lockdown in June was a great challenge for him as his caregivers stopped coming, no gym workouts and no outings for a coffee.

Being his mother and primary carer I feared that this was a hotbed for depression. I scoured the net and chanced upon FlintRehab. As there was a trial period it was safe for us to risk getting it across to Auckland.

His OT checked it out and felt that it was ideal. I can honestly second this.

He enjoys working on it and now after three months can do it on his own. His left hand helps his right hand. The FitMi video explains and shows him what to do, it gives him marks and applauds him too!!

He has to use both sides of his brain. The caregivers are OT students who returned enjoy working on it with him.

In three months there motivation built up in him with a drive to use his right hand. There is definitely a slight improvement in his right hand.

This encourages him as well as the caregivers to try harder.His overall mood is upbeat. He enjoys it, so much so, that it doesn’t matter if his caregiver is away.

FitMi is a blessing.”

Sharat’s review of FitMi home therapy, 10/10/2020

5 stars

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