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Brain Stem Stroke: How It Affects the Body & What to Expect

3D image of brain anatomy with brain stem stroke highlighted in red

The brain stem regulates basic bodily functions like breathing and consciousness. When a stroke occurs in the brain stem, it can lead to major side effects that impair these functions.

Fortunately, most brain stem strokes are relatively small. As a result, the outcome is often optimistic due to the brain’s ability to heal itself.

To maximize outcomes after this type of stroke, it helps to understand which side effects may occur, and how the recovery process goes. This article will explain what to expect on the road to recovery.

How a Stroke Affects the Brain Stem

When a stroke occurs in the brain stem, the supply of blood becomes compromised by a clogged or burst artery. This is a medical emergency as brain cells begin to die from the lack of oxygen-rich blood.

There are 3 different areas of the brain stem: the midbrain, pons, and medulla. A stroke can occur in any of these areas. Furthermore, some strokes that injure the brain stem also affect the cerebellum or other surrounding areas.

When stroke occurs in the brain stem, it can cause atypical symptoms like vertigo and nausea. These are much different than the hallmark symptoms of a stroke, such as slurred speech and arm weakness. As a result, brain stem strokes are harder to diagnose.

If treatment goes well and doctors are able to restore the flow of blood in the brain, the patient can begins recovery to rehabilitate the side effects.

Not all brain stem stroke patients will experience the same side effects, as a stroke can occur in different areas of the brain stem.

Therefore, all stroke patients should ask their doctor or neurologist about the location of their stroke, as it has implications for potential side effects.

Potential Side Effects of Brain Stem Stroke

The brain stem controls basic bodily functions like breathing, consciousness, and heart rate. It also controls the flow of messages between the brain and spinal cord.

As a result, the side effects of a brain stem stroke can affect basic bodily functions and other critical abilities.

Possible side effects of stroke in the brain stem may include:

  • Coma. The brain stem controls states of consciousness, and strokes in the brain stem can result in comatose patients.
  • Locked-in syndrome. Perhaps the grimmest side effect of brain stem stroke is locked-in syndrome, where patients are completely paralyzed except for the eyes.
  • Difficulty breathing. Breathing is one of the basic bodily functions controlled by the brain stem.
  • Dysphagia. Difficulty swallowing is a condition called dysphagia, which may occur after a stroke in the brain stem
  • Nystagmus. This is a vision condition where the eye makes repetitive, uncontrolled movements.
  • Vision problems. Other vision difficulties like double vision can occur after brain stem stroke.
  • Hemiplegia. This refers to weakness on one half of the body. Each side of the brain controls movement on the opposite side of the body. As a result, hemiplegia affect the side of the body opposite to the stroke.
  • Ataxia. Ataxia refers to difficulties with voluntary motor control, resulting in poor balance and tremulous movements. Ataxia is a condition specific to damage to the cerebellum and surrounding areas like the brain stem.
  • Wallenberg’s syndrome. This refers to ataxia on the same side of the body as the injury.
  • Vertigo. Nausea, dizziness, and vertigo may occur at the onset of a stroke in the brain stem and sometimes after the stroke has been treated.
  • Loss of sensation. This can include difficulty sensing temperature, inability to feel pain, numbness, and other sensory issues.

Every stroke is different, and every patient experiences side effects differently.

It’s uncommon for patients to sustain all of these side effects after a stroke in the brain stem. Usually, only one or a few are sustained.

After the medical team reviews the side effects, they can recommend a plan for rehabilitation.

Rehabilitation Plan for Brain Stem Stroke Patients

The after math of a brain stem stroke usually improves with a good rehabilitation program.

During the stroke recovery process, patients are typically sent to inpatient rehabilitation after the hospital if they are able to participate in 3-4 hours of therapy. The intensity of the workload is one reason why recovery occurs rapidly during this time.

There are many different kinds of therapy available during inpatient and outpatient rehab. Your medical team will adjust your recovery plan according to your unique circumstances.

For instance, sensory reeducation therapy is often provided for patients suffering from numbness or loss of sensation. Physical therapy is often prioritized to help patients regain mobility and improve independence.

No matter which type of therapy is pursued, the primary focus is to help spark neuroplasticity and rewire the brain. Although it’s impossible to revive dead areas in the brain stem (or anywhere else in the brain), neuroplasticity allows new areas of the brain to “pick up the slack.”

It takes hard work and consistency, though. Neuroplasticity is activated through massed practice, which involves practicing the skills you want to improve on a regular and consistent basis. Complex skills like swallowing and moving take time to relearn. But the brain can bounce back with enough consistent therapy.

The Road to Recovery

The road to recovery from stroke looks different for everyone. Fortunately, with enough hard work, patients can make remarkable recoveries.

“The typical brain stem stroke is not a massive stroke… Although, if you are locked-in, you could call that a massive stroke, although the injury itself is very small.

“But for the most part, strokes in the brain stem have really nice improvement… with proper rehabilitation, of course,” says Dr. Richard Harvey, medical director of the Center for Stroke Rehabilitation at the Rehabilitation Institute of Chicago.

While the side effects of a brain stem stroke can be significant, a rigorous rehabilitation program can help patients maximize outcomes.

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