The Stroke Network
PO Box 492
Abingdon, MD 21009
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Brainstem
The brainstem
is the stem-like part of the base of the brain that is connected to the
spinal cord.
The
brainstem controls the flow of messages between the brain and the rest
of
the body, and it also controls basic body functions such as breathing,
swallowing, heart rate, blood pressure, consciousness, and whether one
is awake or sleepy.
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Brainstem
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Midbrain
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Pons
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Medulla
Oblongata |
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Midbrain
The midbrain, also called the
mesencephalon, is a small region of the brain that serves as a relay
center for visual, auditory, and motor system information.
It regulates autonomic functions, those
that the body carries out without conscious thought, such as digestion,
heart rate, and breathing rate.
Pons
A major structure in the upper part of
the brainstem is called the pons. The pons has two over-arching roles.
The first is the regulation of breathing. In the pons, there is a
structure called the pneumotaxic center. It controls the amount of air
breathed and breaths per minute, which is known as the breathing rate.
In addition, the pons is involved in the
transmission of signals to and from other structures in the brain, such
as the cerebrum or the cerebellum. The pons is also involved in
sensations such as hearing, taste, and balance. Finally, the pons is
also involved in the regulation of deep sleep.
Medulla Oblongata
The medulla oblongata is located in the
lower portion of the brainstem. It is very important in things like
heart rate and blood pressure. It's responsible for many reflexes in
the body, or involuntarily controls, such as vomiting, sneezing, and
coughing.
A brainstem stroke happens when the brain’s blood
supply is interrupted in this area. This type of stroke can result in
death, since the damaged brainstem can no longer control the body’s
vital functions.
Involuntary
Functions
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Breathing
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Heart Rate
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Swallowing
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Reflexes to seeing and hearing
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Startle
Response |
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Autonomic
Nervous System
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Sweating
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Blood Pressure
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Digestion
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Temperature
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Affects
level of alertness |
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Ability to sleep
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Vestibular
Function
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Sense of balance
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Observed Problems
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Decreased vital
capacity in breathing, important for speech.
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Difficulty with
organization/perception of the environment.
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Balance
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Movement
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Dizziness
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Vertigo
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Nausea
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Sleeping
difficulties
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The brain
stem contains the fibers which connect the brain to the spinal cord and
cerebellum. Strokes within the brain stem may be localized by the
pattern of deficits caused by the interruption of these
nerves.
Brainstem strokes are often caused by mechanical
obstruction of blood vessels, which might happen during a high speed
chiropractic manipulation of the neck, or some other event that causes
a very forceful neck movement, such as after a roller coaster
ride. Vertigo (spinning) is a common early symptom of
brainstem strokes.
A large
stroke in the upper brainstem may sever the connections between the
brain and the body. In such an instance, a person may retain
consciousness and intelligent thought but become entirely paralyzed
except for eye movements. This is called the locked-in syndrome.
Locked-in
Syndrome
A condition
resulting from interruption of motor pathways in the pons,
usually by
infarction. This disconnection of the motor cells in the
lower brainstem and spinal cord from controlling signals issued by the
brain leaves the patient completely paralyzed and mute, but able to
receive and understand sensory stimuli to the
thalamus.
Communication
Communication
may be possible by eye gazing (to letters or words on a
Communication Board), by code using blinking (once for yes
and twice for no), or movements of the eyes (staring at objects,
people, etc).
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stroke affecting the brain stem is potentially life threatening since
this area of the brain controls functions such as breathing and
instructing the heart to beat. Brainstem stroke may also cause double
vision, nausea and loss of coordination.
Thalamus
The
thalamus
is a small structure within the brain located just above the brain stem
between the cerebral cortex and the midbrain and has extensive nerve
connections to both.
It works to correlate several important
processes, including consciousness, sleep, and sensory interpretation.
- Cranial Nerves
The
cranial nerves are composed of twelve pairs of nerves that
emanate from the nervous tissue of the brain.
The function of the cranial nerves is for the
most part similar to the spinal nerves, the nerves that are associated
with the spinal cord. Apart from sensory functions there are
also some that work as motor nerves or mixed nerves.
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Stroke
Warning Signs
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Sudden numbness or weakness of the face, arm
or leg, especially on one side of the
body |
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Sudden confusion, trouble speaking or
understanding |
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Sudden trouble seeing in one or both
eyes |
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Sudden trouble walking, dizziness, loss of
balance or coordination |
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Sudden, severe headache with no known cause |
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