Brain stem stroke: Symptoms, recovery, and outlook

In this article, we take a close look at brain stem strokes, including the symptoms, diagnosis, recovery, and outlook.

What is brain stem stroke?

According to the World Health Organization (WHO), stroke is the “second leading cause of death and the third leading cause of disability” worldwide.

A stroke occurs when the blood supply to a part of the brain is interrupted, either due to a blocked artery or a leaking blood vessel.

The brain stem is located at the base of the brain and is responsible for receiving and relaying information throughout the body.

The brain stem controls essential body functions, such as:

  • breathing
  • swallowing
  • eye movement
  • facial movement and sensation
  • hearing
  • heart rate
  • blood pressure

Brain stem strokes can affect a person’s fundamental bodily functions and may lead to long-term complications.

Types of strokes

There are two main types of strokes, both of which can affect the brain stem:

Ischemic stroke

Ischemic strokes occur when blood clots form in the narrow arteries in the head or neck, cutting off the blood supply to an area of the brain.

Ischemic strokes are the most common type, accounting for 87 percent of all strokes. Around 10 percent of all ischemic strokes affect the brain stem.

A transient ischemic attack (TIA), also called a mini-stroke or a warning stroke occurs when the blood supply to the brain is interrupted briefly. TIAs cause milder symptoms than full ischemic strokes, and most symptoms go away within an hour.

Hemorrhagic stroke

Hemorrhagic strokes, or brain bleeds occur when a weak blood vessel leaks or breaks open, creating swelling and pressure. This pressure damages tissues and cells in the brain.

Hemorrhagic strokes are less common than other types of stroke, but they account for 40 percent of all stroke deaths.

Because the brain stem controls a variety of motor functions, strokes in this area of the brain cause a diverse range of symptoms.

Brain stem strokes can disrupt vital bodily functions, such as:

  • breathing
  • swallowing
  • heart rate

The brain stem receives various signals from the brain and sends them to different parts of the body. Brain stem strokes disrupt these signals, which is why people experience physical symptoms, including numbness or weakness in the face, arms, or legs.

Other common stroke symptoms include:

  • dizziness
  • loss of balance
  • vertigo
  • blurred or double vision
  • problems with speech or swallowing
  • a headache
  • confusion

Anyone can have a stroke, but specific genetic factors, such as family history, gender, race, and age put some people at higher risk for stroke than others.

According to the American Stroke Association, women have more strokes than men and are more likely to die from a stroke than men.

Some risk factors that are unique to women include:

  • use of hormone replacement therapies
  • long-term use of birth control pills in combination with other risk factors, such as smoking
  • pregnancy

People of African-American and Hispanic descent are also at higher risk of stroke.

The majority of strokes occur in people over the age of 65. However, research suggests that the rate of stroke hospitalizations and the presence of stroke risk factors in younger adults has increased significantly.

Medical conditions that increase the risk of stroke include:

  • high blood pressure
  • high cholesterol
  • arterial fibrillation (AFib)
  • diabetes
  • obesity
  • cardiovascular disease (CVD)
  • Lifestyle risk factors

People cannot control genetic factors, but they can control lifestyle factors that increase the risk of stroke. Behaviors that increase high blood pressure or the risk of clot formation can lead to a higher risk of stroke.

Behaviors that can increase the risk of stroke include:

  • smoking tobacco
  • excessive alcohol use
  • illegal drug use
  • a sedentary lifestyle
  • poor diet


An estimated 80 percent of strokes are preventable. People can reduce their risk of stroke by making the following lifestyle changes:

  • monitoring lipid and cholesterol levels
  • controlling blood pressure with medication and behavioral changes
  • controlling medical conditions, such as diabetes
  • quitting smoking
  • eating low-fat, low-sodium diets
  • eating 5 or more servings of fruits and vegetables
  • taking part in regular exercise

Recovery and outlook

A brain stem stroke can result in severe long-term complications. Medication and behavioral changes can help reduce the risk of future strokes.

Physical therapy can improve muscle strength, coordination, and ultimately help people regain lost motor skills.

Occupational therapy can help people improve their cognitive abilities, such as memory, problem-solving, and judgment.

Some people who have had a brain stem stroke and have severe disabilities may require psychological counseling to help them adjust.

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