Brainstem Infarction

Medically reviewed by Drugs.com. Last updated on May 4, 2025.

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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 controls your ability to speak, hear, and swallow. It also controls your breathing, heartbeat, blood pressure, balance, and eye movements.

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IV:

You may need an IV to give you medicine or liquids if you cannot swallow. Some IV lines can also be used to collect blood samples.

Medicines:

• Antipyretics decrease a fever.
• Thrombolytics break apart blood clots.
• Anticoagulants and antiplatelets prevent blood clots.
• Pain medicine may be given. Do not wait until the pain is severe before you ask for more pain medicine.
• Sedatives help decrease the pressure in your brain, and can also help decrease pain.
• Other medicines may be used to treat diabetes or high blood cholesterol, or to prevent seizures. Medicine may be given to keep your blood pressure at a certain level if it is too high or too low.

Tests:

• Blood tests may be used to monitor your condition while you are being treated for your stroke. You may need tests to check if you are getting the right amount of medicine to prevent clots. You may need blood gas tests to check your oxygen level if you are on a ventilator.
• CT or MRI pictures may show blood flow blockage in your brain that may cause a stroke. The pictures can also show bleeding or damage if you already had a stroke. You may be given contrast liquid to help any bleeding or damage show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
• Arteriography is a type of x-ray used to check your arteries for blood flow blockage and bleeding.

Drugs used to treat this and similar conditions

Monitoring:

• Extra oxygen may be given if your oxygen level drops too low. You may need a ventilator to give you oxygen if you cannot breathe on your own.
• Healthcare providers will check your vital signs. Vital signs include blood pressure, heart rate, breathing rate, and temperature. The providers will also ask about your pain.
• Intake and output means the amount of liquid you are getting and how much you are urinating is recorded. You may need a Foley catheter. A Foley catheter is a tube placed in your bladder to drain your urine into a bag. Healthcare providers will remove the catheter as soon as possible, to prevent infection.
• A neurologic exam can show healthcare providers how well your brain works after an injury or illness. A provider will check how your pupils react to light. The provider may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.
• An ICP monitor is used to keep an ongoing measurement of the pressure inside your skull. A small tube is put through your skull and connected to a screen.

Treatment:

• Physical and occupational therapy may help you recover more quickly and prevent muscle shortening and bedsores. You may also learn new ways to do things such as dressing and bathing. Physical and occupational therapists may exercise your arms, legs, and hands. They will help you be active as soon as possible after your stroke. You will learn to move carefully to lower your risk for falling.
• Bladder and bowel training may help if you have trouble controlling your urine and bowel movements. A bladder training program can teach you ways to control when you urinate. A bowel program can help you learn how to plan for bowel movements. This training can help your skin stay clean and dry, and help prevent skin breakdown.
• Swallow therapy can help prevent you from breathing food or liquid into your lungs. A therapist can help you learn safe ways to swallow.
• You may need to wear pressure stockings. The stockings are tight and put pressure on your legs. This improves blood flow and helps prevent clots.
• You may need to wear inflatable boots after surgery. The boots have an air pump that tightens and loosens different areas of the boots. This device improves blood flow and helps prevent clots.

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• ticlopidine
• isoxsuprine

A feeding tube

may be needed if you cannot swallow food or liquids. The tube may also be used to let air or fluids out of your stomach.

Surgery:

• A tube may be placed into your skull to drain extra fluid and to check the pressure in your brain.
• A craniotomy is a small hole put in your skull to relieve pressure and remove blood from around your brain.
• A blood vessel filter helps prevent complications from a blood clot in your leg (DVT).

RISKS:

• A BSI is life-threatening, and you may not recover from it. Blood clots may break loose and travel to your lungs or brain. Your breathing may get worse. You may need a machine to help you breathe. You may go into a coma. You may be paralyzed. You are at greater risk for falling after a stroke. You may develop medical problems such as muscle shortening or bedsores. Your brain may be damaged by the stroke, and you may have seizures. Without treatment, the damage caused by a stroke can get worse, and your risk for another stroke increases.
• Even with treatment, you may have lasting problems talking, thinking, or moving your body. You may not be able to care for yourself or live alone. You could have another stroke, even after treatment.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.

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