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Brain Stem Infarction

WHAT YOU NEED TO KNOW:

A brainstem infarction (BSI) is a stroke that happens when blood cannot flow to your brainstem. When oxygen cannot get to an area of the brain, tissue in that area may get damaged. Your brainstem allows you to speak, hear, and swallow. It also controls your breathing, heartbeat, blood pressure, balance, and eye movements.

DISCHARGE INSTRUCTIONS:

Medicines:

  • Antiplatelets: These prevent blood clots. Aspirin is an antiplatelet. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead. Do not take more or less aspirin than directed.
  • Anticoagulants: You may need to take an anticoagulant to prevent blood clots. Anticoagulants prevent blood clots by thinning the blood. Warfarin is an anticoagulant. Take your medicine exactly as directed. Tell your primary healthcare provider if you forgot to take it, or if you took too much. Anticoagulants may cause you to bleed or bruise more easily. Use a soft toothbrush and an electric shaver. Wear medical alert jewelry or carry a card that says you take an anticoagulant. Tell all caregivers, including your dentist, that you take this medicine.
  • Other medicines: You may need medicine to treat diabetes, high cholesterol, depression, or to prevent seizures. You may also need medicine to keep your blood pressure at a certain level if it is too high or too low.
  • Take your medicine as directed. Call your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your primary healthcare provider or neurologist as directed:

You may need to come in for regular tests of your brain function. If you are taking warfarin, you will need to come in for regular blood tests. Your INR levels will also need to be checked. These tests help make sure you are taking the right amount of warfarin. Write down your questions so you remember to ask them during your visits.

Rehabilitation:

Rehabilitation (rehab) is an important part of treatment. Physical therapists help strengthen your arms, legs, and hands. You may learn exercises to improve your balance and movement to decrease your risk of falling. Occupational therapists teach you new ways to do daily activities, such as getting dressed. A speech therapist helps you relearn or improve your ability to talk and swallow.

Prevent another stroke:

  • Manage health conditions: High blood pressure, diabetes, and high cholesterol all increase your risk of stroke. Take your medicines as directed. Do not stop taking these medicines. Follow your primary healthcare provider's instructions to check your blood pressure and blood sugar levels. Write the numbers down to show him.

  • Eat healthy foods: The foods you eat can help prevent or manage high blood pressure, high cholesterol, and diabetes. Eat foods that are low in fat, cholesterol, salt, and sugar. Eat at least 5 servings of fruits and vegetables each day. Include food that are high in potassium, such as potatoes and bananas. If you take warfarin, it works best when you eat about the same amount of vitamin K each day. Vitamin K is found mainly in leafy green vegetables. Ask your primary healthcare provider for a list of other foods that contain vitamin K.
  • Reach or stay at a healthy weight: Weight loss can decrease your blood pressure and your risk of stroke. Ask your primary healthcare provider how much you should weigh and how to lose weight safely. Get 30 minutes of exercise each day. Ask which exercises you should do. You will need to exercise carefully after a stroke so you do not fall.
  • Limit alcohol: Men should limit alcohol to 2 drinks per day. Women should limit alcohol to 1 drink per day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
  • Do not use street drugs or smoke cigarettes: Your risk of another stroke increases if you use drugs such as cocaine, or you smoke cigarettes. Ask your primary healthcare provider for help if you are having trouble quitting.

Know the FAST test to recognize the signs of a stroke:

  • F = Face: Ask the person to smile. Drooping on 1 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: Call 911 if you see any of these signs. This is an emergency.

Contact your primary healthcare provider or neurologist if:

  • Your blood pressure is higher or lower than you were told it should be.
  • You have skin tears, or sores on your heels, head, or buttocks from lying in bed.
  • You have bowel movement problems.
  • You have questions or concerns about your condition or care.

Seek care immediately or call 911 if:

  • You have a seizure.
  • You are bleeding from your rectum or nose.
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You suddenly feel dizzy, lightheaded, and have shortness of breath.
  • You have chest pain. You may have more pain when you take a deep breath or cough. You may cough up blood.
  • You have weakness or numbness in your arm, leg, or face.
  • You are confused and have problems speaking or understanding speech.
  • You have vision loss or a severe headache.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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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