Prognosis of a Brain Stem Stroke

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A stroke happens suddenly and causes an interruption of blood flow to the brain. This "brain attack" can occur in one or more locations within the brain, including the brain stem. By understanding the characteristics of this type of stroke and the prognosis, or likely outcomes and chance of recovery, caregivers can make informed decisions regarding treatment for victims of brain stem stroke.

Brain Stem

  • When a stroke occurs in the brain stem the resulting damage can be life threatening as it can disrupt the most basic life functions such as communication, motor control, digestion, heartbeat, breathing, alertness and awareness of one's surroundings. Prognosis for recovery improves if the brain stem stroke is quickly diagnosed and treated. Much of the damage caused by a brain stem stroke is related to motor skills rather than cognitive skills, so patients are more able to fully participate in their rehabilitation.

Communication

  • The ability to regain communication skills among brain stem stroke survivors is fundamental to much of their recovery. Dysarthria is a speech disorder that affects approximately 30 percent of those who have had a stroke, causing unclear, quiet or slurred speech. Many brain stem stroke survivors often improve their speech skills through speech therapy. However, some brain stem stroke survivors experience Locked-In Syndrome in which they are unable to speak or move any body part other than their eyelids. Prognosis is poor for improvement from Locked-In Syndrome, as many do not recover from this condition.

Swallowing

  • Dysphagia is a condition common to brain stem stroke victims. It describes difficulty with swallowing and is experienced by as many as 65 percent of stoke victims. Prognosis for full or partial recovery ranges from being excellent to low, depending on the severity and patient's ability to follow therapy guidelines. Therapy consists of exercise, use of techniques and postures to enable better swallowing and diet modification.

Mobility

  • Since muscle control is damaged by a brain stem stroke, a victim's mobility is severely affected. Muscle control affects voluntary movement of hands, arms and legs. The prognosis for motor recovery is most positive the first three months after a stroke, after which patients tend to plateau. Improvement can slowly continue for the next six months to a year with some patients showing markedly positive improvement for the next several years. Prognosis for recovery is good even for those who have had extensive cranial nerve damage.

Balance

  • Many brain stroke victims experience balance problems and vertigo, which is a sensation of spinning or movement where there is none. Vertigo is an early symptom of brain stem stroke and is usually treated with medication and rehabilitation exercise. Prognosis for vertigo and balance improvement depends on the extent of the brain damage. Balance can be improved by strengthening affected muscles and physical therapy focused on balancing skills.

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