BRAIN-STEM STROKE – AN OVERVIEW

Stroke usually occurs when the blood supply to the brain is interrupted. When this happens, it stops the blood supply to a particular partof the brain and as a result the cells in that area tend to die due to lack of essential oxygen and nutrients that the blood carries. When the part involved in the stroke is the brain-stem, which connects the brain and the spinal cord, the stroke is referred to as a brain-stem stroke or a brainstem infarction (BSI)

The brain stem is what allows you to speak, hear and swallow. It also controls Breathing, heartbeat, blood pressure, digestion, eye movements and balance.

Causes Of A Brain-Stem Stroke:

Most often, brainstem strokes are ischemic strokes, wherein a blood clot interrupts the supply of blood to the brain.In very rare circumstances, it may also be due a haemorrhagic stroke which occurs when the blood vessels burst and cause damage to the brain tissue.

Symptoms Of A Brain-Stem Stroke:

The brainstem stroke typically have much severe symptoms than the other strokes. The most common symptoms include :

  • Dizzyness.
  • Respiratory difficulties
  • Inability to swallow
  • Loss of co-ordination and balance
  • Blurred vision
  • Nausea
  • Uneven pupil sizes
  • Numbness or weakness on any one side of the face/body

Complications Of A Brain-Stem Stroke :

In some cases, a brain- stem stroke can cause a person to lose their sense of smell and taste.

There are also cases reported of patients experiencing psychosis in terms hallucinations or delusions. While hallucination is seeing and hearing things that don’t actually exist or happen, delusions refers to strongly believing in something that simply isn’t true.

In some very severe cases, individuals suffering a brain stem stroke become completely paralyzed, unable to speak but can receive and understand what happens around them. This is referred to as the “Locked in syndrome”.

Diagnosis Of A Brain-Stem Stroke:

Brain-stem stroke is considered to be a life threatening medical emergency and treating one is a bigger challenge than any other stroke. It is usually diagnosed with the help of imaging tests such MRI,CT Doppler Ultrasound or Angiogram. It might also include monitoring your heart function using an Echo and an ECG and blood tests to monitor and kidney and liver functions. Neurologists find it easier to differentiate a brain stem stroke from all the other types simply by noticing the very specific symptoms that are characteristic to this type of stroke.

Treatment Of A Brain-Stem Stroke:

The major focus on immediate treatment is dissolve or remove existing clots in case of a Ischemic stroke and to stop the brain bleed in case of a haemorrhagic stroke. They are usually established through medications and surgery.

Medicines:

In the case of an Ischemic stroke, medications are prescribed to:

  • Dissolve any clots that exists and prevent any further clots from forming.
  • Control Sugar, Cholesterol and Blood pressure and bring it to optimal levels
  • Thin Blood
  • Treat any irregular rhythms in the heartbeat

In the case of a Haemorrhagic stroke, medications are prescribed to:

  • Control Blood pressure
  • Counter-effect the blood thinners you may already be using.
  • Reduce the impact of the brain bleed.

Surgery:

For an ischemic stroke,

  • a procedure called embolectomy is done wherein a catheter is used to remove the clot or administer the clot dissolving drugs.
  • The carotid artery is widened and a tube inserted to keep it open.

For a hemorrhagic stroke, a clip is placed on the aneurysm to stop further bleeding.
In severe cases, the patient maybe latched onto ventilator support for breathing.

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