December 8, 2023

Car or motor accidents, falls, and assaults can lead to severe head trauma and brain stem injury. The brain stem comprises three components. It includes the medulla oblongata, pons, and the midbrain. The brain stem not only controls critical bodily functions but also acts as the link between the rest of the brain and the spinal cord. It means any damage to the brain stem can affect other functions.

The brain stem is susceptible to injury because of its location and is often fatal. It affects the quality of life as brain stem injury can change the patients’ memory and personality. Also, damage to the brain stem can paralyze the person, and very few patients recover from severe injury. 

Symptoms of brain stem injury

The symptoms of brain stem injury include the following 

  • Dizziness
  • Irregularity in breathing
  • Abnormal sleeping patterns
  • Repetitive jerky eye movements
  • Balance issue
  • Loss of sense of smell
  • Impaired vision
  • Altered heart rate
  • Paralysis
  • Coma
  • Loss of some reflexes.

Diagnosis of brain stem injury

A medical professional will conduct an imaging test, like an MRI scan, angiogram, or CT scan to confirm the diagnosis.

Effects of brain stem injury

Most times, brain stem injury results from swelling and inflammation from other severe head injuries. Swelling pushes the brain to stem against the hard covering known as the skull. This causes damage to the brain and stem. The likelihood of brain stem injury is high if the patient suffers from a diffuse axonal injury. It tears the brain cells in the medulla or pons. Some common effects of brain stem injury are as follows. 

  • Coma: The brain stem has a network of neurons. These are known as the reticular activating system. The primary function of this system is to help in waking up. However, when the brain stem is damaged because of injury, the reticular activating system is compressed; it cannot wake up and cause a coma. In many patients, the comas last until the swelling subsides. After that, the patient will usually pass through three stages of consciousness before becoming fully alert. These stages are as follows.  
  1. Vegetative state: In this stage, eyes may open and shut. 
  2. Minimal conscious state: During this stage, the patient can respond by smiling or blinking eyes. However, the person falls in and out of consciousness.
  3. Confusional state: In this stage, the patient is aware and awake but does not have full control over the behavior.

Full recovery chances are higher in those patients who make fast progress through the stages of consciousness. 

  • Locked-In syndrome: With the severely damaged brain stem, the patients are paralyzed and cannot move any body  parts except their eyes. These patients can hear and understand everything going on around them but cannot communicate.
  • Swallowing problems: Sometimes, brain stem injury can lead to swallowing and gag reflex problems. Such patients are at a higher risk of choking on their saliva. Swallowing problems after brain stem injury are treatable. A speech therapist can help to overcome this problem with exercises. 
  • Respiratory issues: The function of the medulla is to control breathing. It senses the carbon dioxide level in the blood and adjusts the respiratory rate. However, any damage to the medulla can interfere with its function, and it cannot detect the carbon dioxide level in the blood. This gives rise to breathing issues in response.
  • Sensory Problems: Brain stem damage can cause problems with balance and sensation. The brain stem injury leads to numbness and weakness in the muscle. 

Treatment of brain stem injury

Brain stem injuries cause fatal problems and need intensive treatment. The effective way to address the symptoms is to trigger neuroplasticity. There are various therapies patients can take to engage in neuroplasticity and recover function. Some of them include the following. 

  • Physical therapy: A physical therapist can help to accomplish neuroplasticity. If the muscles are weak or stiff, the therapist can help to move them. This passive range of motion exercises triggers the brain and rekindles the neural network. Some patients may need electrical stimulation. These impulses are directly targeted to the muscle through the electrodes. The electrical impulses stimulate the nerves in the brain stem to start the neural repair process. Also, the physical therapist will have the patient practice task-specific exercises like walking, etc.
  • Occupational therapy: It helps to regain independence. During this therapy, the focus is on practicing specific skills essential for day-to-day life, such as self-care, social skills, home management, etc.
  • Speech therapy: For improving swallowing, speech therapy is a must. A speech therapist can also help with cognitive or communication skills that can be impaired after the brain stem injury.

Brain stem injuries are more serious and treatment can be expensive. Recovery from this damage can take a long time. However, extended therapy and rehabilitation have helped many patients.