A 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. Brain stem stroke may also cause double vision, nausea and loss of coordination. The brain stem also controls less essential abilities such as articulate speech.  A Communication Board might be necessary in case of loss of speech. 
 

Locked-in Syndrome

A condition resulting from interruption of motor pathways in the ventral pons, usually by infarction. This disconnection of the motor cells in the lower brain stem 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; communication may be possible by code using blinking, or movements of the jaw or eyes, which can be spared.

Persistent Vegetative State (PVS) is subject to a high degree of error as a diagnosis, a high measure of confusion as to definition, and an inflation of the role of the expert. This article from Issues in Law and Medicine discusses these issues in detail.

 

The signs and symptoms of a brainstem stroke

The brainstem contains the fibers which connect the brain to the spinal cord and cerebellum and also emits the nerves which project to the face and head. Strokes within the brainstem may be localized by the pattern of deficits caused by the interruption of these nerves. The cerebellum functions in the coordination of movement. The clumsy hand-dysarthria syndrome is produced by injury to cerebellar projections and to the motor centers of face which serve articulation. Cerebellar injury alone may produce a characteristic cerebellar tremor or gait. 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.

Functions Breathing Heart Rate Swallowing Reflexes to seeing and hearing  (Startle Response) Controls sweating, blood pressure, digestion, temperature  (Autonomic Nervous System) Affects level of alertness. Ability to sleep. Sense of balance (Vestibular Function)	Observed Problems Decreased vital capacity in breathing, important for speech. Difficulty with organization/perception of the environment. Problems with balance and movement. Dizziness and nausea (Vertigo). Sleeping difficulties (Insomnia, sleep apnea)
Learn about the: 12 Cranial Nerves

 

	Communication Board
	ALIS
	Brain Function Cerebellum and Brain Stem
	Blood Supply of the Brain
	National Institute of Neurological Disorders and Stroke