Brain Stem Infarction

WHAT YOU SHOULD KNOW:

Brain Stem Infarction (Aftercare Instructions) Care Guide

  • A brainstem infarction (stroke) happens when blood flow to a part of the brain called the brainstem suddenly decreases or stops. The brainstem is made up of the midbrain, pons, and medulla. Blood vessels (arteries) carry blood with oxygen and other nutrients to your brain and brainstem. When oxygen cannot get to the brain or brainstem, cells are damaged and can die within minutes to hours. A blood clot that blocks an artery causes an ischemic stroke. An artery that ruptures (breaks) and bleeds causes a hemorrhagic stroke. After a stroke, you may be unable to move parts of your body. You may have trouble talking, swallowing or walking. A brainstem infarction can also change the way you think and act.



  • Caregivers use tests, such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI), to learn more about your stroke. You may also need a carotid ultrasound or angiography. Treatment may include medicine or surgery. You may need a machine (ventilator) to help you breathe. You may need physical, occupational and speech therapy to help you learn new ways to do the things that you used to do. Treatment and therapy may help you return to doing things that you were able to do before the stroke. Diet and lifestyle changes, such as stopping smoking and getting more exercise, may help prevent another stroke.

INSTRUCTIONS:

Medicines:

  • Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.

  • Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.
  • Anticoagulants: Anticoagulants are also called blood thinners. This medicine helps prevent clots from forming in the blood.

  • Antiplatelets: Antiplatelets work against platelets to prevent blood clots from forming. Platelets are a type of blood cell that start to form blood clots.

  • Thrombolytics: Thrombolytics are used when a stroke is caused by a clot in a blood vessel. Thrombolytics break apart clots, and help blood to flow more easily through a blood vessel.

  • Anticonvulsant medicine: Anticonvulsants are given to control seizures.

  • Blood pressure medicine: This medicine may be given to lower your blood pressure. Keeping your blood pressure under control protects your heart, lungs, brain, kidneys, and other organs.

Ask your caregiver when to return for a follow-up visit.

Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Rehabilitation:

Rehabilitation may help you get stronger and able to take care of yourself. It can also help you return to doing some or all of your usual activities.

  • A speech or swallowing therapist may work with you to help you swallow and speak. If you have trouble swallowing, you may need to be fed through a gastrostomy tube in your stomach. You or a family member or friend may be taught how to use the tube. Ask caregivers for information on how to use a gastrostomy tube. If you can swallow, you may need to drink thick liquids and have blended food at first. Over time, you may be able to return to your usual diet. You may have speech problems, such as aphasia and dysarthria, after a stroke. Other people may not be able to understand what you are saying. A therapist will work with you to help your speech improve.

  • Physical and occupational therapists are caregivers who can help you grow stronger and better able to take care of yourself. Being active can help prevent problems such as blood clots, pneumonia, skin breakdown, and contractures. Contractures occur when unused muscles shorten over time, and decrease your ability to extend your arms and legs. Therapy can help you cope with problems such as feeling very tired and weak. Caregivers will help you with exercise programs that may improve your balance and help prevent you from falling. They will help you get and use equipment, such as a cane or wheelchair. Wear support stockings to help prevent blood clots from forming in your legs.

  • Talk to caregivers about your feelings and concerns. You may feel very sad, angry or helpless. If you have pain, you may find it hard to get through each day. You may be worried about how you will work, or get along with your family or friends. Caregivers can help you cope with these feelings. You may want to join a support group. This is a group of people who also have had strokes. Ask caregivers for more information about stroke support groups.

Preventing skin breakdown:

You may need a special mattress called an egg crate or an air mattress. Ask someone to help you turn in bed if you cannot do this yourself. Changing your position often while in bed will help prevent skin breakdown (pressure sores). Skin breakdown can happen when pressure on your skin decreases blood flow and oxygen to the area, causing sores to form and grow. Ask your caregiver for more information about preventing pressure sores.

Things that you can do to help prevent a brainstem infarction:

  • Do not smoke. Do not smoke tobacco products, or use illegal (street) drugs. Smoking or using street drugs increases your risk of having a stroke. Certain street drugs cause quick changes in blood pressure, and can cause a stroke. The risk of having a stroke increases with the more tobacco products that you smoke.

  • Do not drink too much alcohol. Alcohol is found in beer, wine, and liquor, such as vodka and whiskey. Drinking a lot of alcohol can increase your risk of having a stroke. Women should not drink more than one drink a day, and men should not drink more than two drinks a day.

  • Exercise regularly. Talk to caregivers about the best exercise plan for you. Exercise can help decrease blood cholesterol levels and decrease your blood pressure. Do exercise, such as walking, every day for at least 30 minutes (one-half hour).

  • Change your diet. If you have high blood cholesterol, decreasing it may decrease your risk of having a stroke. Eat food that is low in cholesterol and fat. If you have high blood cholesterol levels, talk to your caregiver about diet changes that you can make to help decrease it. Eat more fruit and vegetables every day. Doing this may decrease your risk of having a stroke. Eating a diet that is high in salt can increase your blood pressure. Having high blood pressure increases your risk of having a stroke. Ask caregivers for help in choosing the best eating plan for you. Weighing more than what caregivers suggest increases your risk of having a stroke. Talk to caregivers if you need to lose weight.

  • Manage diabetes. Manage your blood sugar level if you have diabetes. Talk to your caregiver about your diet, exercise, and medicines. Making changes to these may help you keep your blood sugar levels within the best range for you.

  • Check your blood pressure. Ask your caregiver for more information about checking your blood pressure.
    Picture of how to take your own blood pressure

Signs that show if someone is having a stroke:

Use the F.A.S.T. test to check for signs that show if another person is having a stroke:

  • F= Face: Ask the person to smile. Drooping on one side of the mouth or face is a sign of a stroke.

  • A= Arms: Ask the person to raise both arms. One arm that slowly comes back down or cannot be raised is a sign of a stroke.

  • S= Speech: Ask the person to repeat a simple sentence that you say first. Speech that is slurred or strange sounding is a sign of a stroke.

  • T= Time: If you see that the person has any of these signs, it is an emergency. Call 911 to activate the EMS (emergency medical service). Ask for an ambulance to take the person to the nearest hospital.

CONTACT A CAREGIVER IF:

  • Your blood pressure is higher than your caregiver has told you it should be.

  • During your recovery, new sores have come on places such as your heels, elbows, or buttocks.

  • You are having trouble with your exercises.

  • You have chest pain or trouble breathing that is getting worse over time.

  • You have questions or concerns about your stroke, your medicine, or your care.

SEEK CARE IMMEDIATELY IF:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You suddenly feel lightheaded and have trouble breathing.

  • You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may also cough up blood.

  • You feel very sad and have began to use street drugs, or drink too much alcohol.

  • You feel like hurting or killing yourself.

  • You have one or more signs or symptoms of a stroke. Signs and symptoms of a stroke may happen suddenly. Do not drive yourself to the hospital. Get medical care right away if you have any of the following:

    • A very bad headache. This may feel like the worst headache of your life.

    • Dizziness. You may feel too dizzy to stand up.

    • Weakness or numbness in your arm, leg, or face. This may happen on only one side of your body.

    • Confusion, or trouble speaking.

    • Unable to see out of one or both of your eyes.

Copyright © 2011. Thomson Reuters. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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