General Topics

Symptoms and Treatment for Brain Stem Stroke | Cardiology

What is a brain stem stroke? 

The brain stem stroke regulates breathing, eye movement, facial movement, heart rate, and blood pressure. Sitting just above the spinal cord, the brain stem controls your breathing, heartbeat, and blood pressure. It also controls your speech, swallowing, hearing, and eye movements. Impulses sent by other parts of the brain travel through the brain stem on their way to various body parts.

We’re dependent on brain stem function for survival. A brain stem stroke threatens vital bodily functions, making it a life-threatening condition. When the blood supply to a part of the brain is cut off, a stroke occurs because the blocked artery or blood vessels are leaking. The brainstem is located at the base of the brain and is responsible for receiving and transmitting information throughout the body.

The brain stem regulates essential bodily functions, namely:

  • Breathing
  • Swallow
  • Eye movement
  • Facial movement and sensation
  • Listening
  • Heart rate
  • Blood pressure
  • Brain stem strokes affect a person’s basic bodily functions and can lead to chronic problems.

Symptoms of brain stem stroke

Dizziness and loss of balance are common symptoms of a stroke. Because the brain stem regulates different types of motor functions, strokes in this area of the brain can cause a wide variety of symptoms. Brainstem strokes affect important bodily functions, including:

  • Breathing
  • Swallow
  • Heart rate

The brain stem receives different signals from the brain and sends them to different parts of the body. Brainstem strokes interrupt these signals, so people may experience physical symptoms, such as numbness or weakness in the face, arms, or legs.

Other common symptoms of a stroke:

  • Dizziness
  • Loss of balance
  • Vertigo
  • Blurred or double vision
  • Trouble speaking or swallowing
  • Headache
  • Confusion

Stroke syndromes of the brain system

Some stroke syndromes of the brain system have an unrelated set of symptoms because their control is in small concentrated areas of the brain system that share the same blood supply.

Ondine’s curse: Ondine’s curse due to a lower spinal injury affects voluntary breathing.

Weber syndrome: Weber syndrome is a stroke of the midbrain that causes weakness in the front of the body, which is accompanied by weakness of the eyelids and weakness of eye movements.

Blockage syndrome: Blockage syndrome affects strokes and leads to complete paralysis and inability to speak, the ability to move consciousness, and intact eyes. This may be due to a very abnormal salt and fluid balance.

Wallenberg syndrome: Also known as a lateral spinal syndrome, Wallenberg syndrome causes sensory deficits of the face on the same side as stroke and sensory deficits of the body.

Types of brain stem stroke 

There are two main types of strokes, both of which affect the brain stem:

Ischemic stroke:

  • Ischemic strokes occur when blood clots form in narrow arteries in the head or neck and cut off the blood supply to an area of the brain.
  • Ischemic strokes are the most common type, accounting for 87% of all strokes. About 10% of all ischemic strokes affect the brain stem.
  • A transient ischemic attack (TIA), also known as a mini-stroke or warning stroke, when the blood supply to the brain is briefly interrupted. TIAs cause milder symptoms than full ischemic strokes, and most symptoms clear up within an hour.

Brain-vascular hemorrhagic accident:

  • Brain bleeding or hemorrhage occurs when weak blood vessels leak or open, creating swelling and pressure. This stress damages the tissues and cells of the brain.
  • Hemorrhagic strokes are less common than other types of strokes but account for 40 percent of all stroke deaths.

Risk factors of brain stem stroke

High blood pressure increases the risk of stroke. Anyone can have a stroke, but specific genetic factors such as family history, gender, race, and age put some people at higher risk for stroke than others. Women have more strokes than men and are more likely to die from a stroke than men.

Some risk factors specific to women:

  • Use of hormone replacement therapies
  • Long-term use of birth control pills in combination with other risk factors such as smoking
  • The pregnancy
  • People of African American and Hispanic descent are also at risk for stroke.
  • Most strokes occur in people over the age of 65. However, research suggests that the rate of stroke hospitalizations and the presence of risk factors for stroke in young children has increased significantly.

Medical conditions that increase the risk of stroke:

  • Hypertension
  • High cholesterol
  • Atrial fibrillation (AFib)
  • Diabetes
  • is blackberry
  • Heart disease (CVD)
  • Lifestyle risk factors

People cannot control genetic factors, but they can control lifestyle factors that increase the risk of stroke. Behaviors that increase the risk of high blood pressure or clotting increase the risk of stroke.

Behaviors that increase the risk of stroke:

  • Smoke tobacco
  • Excessive drinking
  • Consumption of illicit drugs
  • Sedentary lifestyle
  • Lack of food 

Diagnosis of brain stem stroke

Brain stem stroke is a fatal medical emergency. If you have symptoms that indicate a stroke, your doctor may order imaging tests such as an MRI, CT scan, Doppler ultrasound, or angiogram. The cardiac function test may include an EKG and an echocardiogram. Additional diagnostic procedures may include blood tests, as well as kidney and liver function tests. 

Treatment for brain stem strokes

When an ischemic stroke occurs, the first line of treatment is clotting or drawing the blood. If a stroke is diagnosed quickly, blood thinners can be given. If possible, a catheter can be used to clot during a procedure called an embolectomy. In some cases, angioplasty and stenting are used to widen and keep the artery open. Bleeding For a stroke, the bleeding must stop.

Sometimes a clip or coil is placed over the aneurysm to stop the bleeding. Medications to reduce clotting may also be needed. During this time, your medical team will need to take extra steps to keep your heart and lungs working. Brain stem stroke is a medical emergency. You need immediate treatment to save lives and reduce the risk of permanent complications.

Treatment depends on the type, location, and severity of the stroke:

Ischemic stroke: In the treatment of ischemic stroke, blood flow is restored through clotting. The methods include the following:

  • Anticoagulant drugs, such as tissue plasminogen activator (T-PA), help dissolve clots and restore blood flow to the affected area.
  • Antiplatelet drugs such as warfarin. The doctor may prescribe aspirin if a person has a lower risk of having a heart attack or stroke and bleeding. Current guidelines do not recommend the use of aspirin as in the past.
  • Endovascular therapy, which is a surgical procedure that involves the use of mechanical reclaimers to clot the blood.
  • Other devices, such as balloons or stents, can be used to open narrow blood vessels and improve blood flow.

Brain-vascular hemorrhagic accident: Treatment of hemorrhagic strokes focuses on controlling bleeding and reducing stress on the brain. Treatment methods:

  • Give medicine to control blood pressure and prevent seizures.
  • Spiral embolization, which is a surgical procedure that helps blood to clot in a weakened vessel. Clotting reduces bleeding and prevents blood vessels from reopening.
  • Once bleeding in the brain has been controlled, doctors can perform surgical procedures to prevent the ruptured blood vessel from bleeding again.

Prevention of brain stem strokes

It is estimated that 80 percent of strokes are preventable. People can reduce their risk of stroke by making the following lifestyle changes:

  • It controls the levels of lipids and cholesterol
  • Control blood pressure with medications and behavior changes
  • Manage medical conditions like diabetes
  • Give up smoking
  • Eat a diet low in fat and sodium
  • Make sure you have plenty of fresh fruits and vegetables in your diet
  • At least 150 minutes of moderate-intensity aerobic exercise per week or at least 75 minutes of vigorous aerobic exercise per week
  • Restoration and perspective
  • Brain stem stroke can lead to serious chronic problems. Medications and behavior changes can help reduce the risk of future strokes.
  • Physical therapy improves muscle strength and coordination and ultimately helps people regain lost motor skills.
  • Speech and language and occupational therapy can help people improve their cognitive skills, such as memory, problem-solving, and judgment.
  • Some people with stroke and severe disabilities need counseling to adjust.

Everything You Need to Know About Headache | Neurology

Overview of headache

A headache is a very common condition that causes pain and discomfort in the head, scalp, or neck. It’s estimated that 7 in 10 people have at least one headache each year.

Headache can sometimes be mild, but in many cases, it can cause severe pain that makes it difficult to concentrate at work and perform other daily activities. Most headaches can be managed with medication and lifestyle changes.

What are the symptoms of a headache?

  • Dull, aching head pain
  • The sensation of tightness or pressure across your forehead or on the sides and back of your head.
  • Tenderness on your scalp, neck and shoulder muscles.

Tension headaches are divided into two main categories episodic and chronic.

Episodic tension headaches

Episodic tension can last from 30 minutes to a week. Frequent episodic tension pain occurs less than 15 days a month for at least three months. Frequent episodic tension headaches may become chronic.

Chronic tension headaches

This type of pain lasts hours and may be continuous. If your headaches occur 15 or more days a month for at least three months, they’re considered chronic.

Treatment for headache

Some people with tension headaches do not seek medical help and do not try to treat the pain themselves. Unfortunately, repeated use of over-the-counter (OTC) pain relievers can lead to another type of pain, and a more severe.


Both prescription and over-the-counter medications are available:

  • Common over-the-counter pain relievers are often the first line of treatment. These include aspirin, ibuprofen (Advil, Motrin IB, others), and naproxen (Alev).
  • Combined drugs. Aspirin or acetaminophen or both in combination with the same caffeine or narcotics. Combination medications are more effective than single-substance pain relievers. Most combination drugs are available OTC.

Lifestyle and home remedies

Rest, ice packs or a long, hot shower may be all you need to relieve this pain. A variety of strategies can help reduce the severity and frequency of chronic tension without using medicine. Try some of the following:

  • Manage your stress level. One way to help reduce stress is to plan and manage your day. Another way is to allow more time to relax. If you find yourself in a stressful situation, back off.
  • Go hot or cold. Applying heat or ice, which you like, can reduce tension headaches in sore muscles. To warm up, use a set of low heating pads, a hot water bottle, a warm compress, or a hot towel. A warm bath or shower can also help. For the cold, wrap ice, ice packs, or frozen vegetables in a cloth to protect your skin.
  • Perform your posture. Good posture helps keep muscles away from tension. When standing, roll your shoulders back and keep your head level. Pull your abdomen and glutes. When sitting, make sure your thighs are parallel to the ground and your head doesn’t slow down.

Tips for using over-the-counter pain relievers

Over-the-counter pain relievers are safe when used as prescribed. But keep the following precautions in mind:

  • Know the active principles of each product. Be sure to read the entire label.
  • Do not exceed the recommended dose on the package.
  • Carefully review how you use pain relievers and all medications. It is very easy to overdose on yourself.
  • Consult your doctor before taking aspirin, ibuprofen, naproxen, or other non-steroidal anti-inflammatory drugs (NSAIDs).
  • Consult your doctor before taking acetaminophen if you have kidney or liver problems.

Types and Causes of Migraine | Neurology

What is a migraine?

Migraine is a neurological circumstance that can cause several symptoms. It is often identified by severe and weakening headaches. Symptoms can include nausea, vomiting, slurred speech, numbness or tingling, and sensitivity to light and sound. These are often hereditary and distress people of all ages.

The diagnosis of migraines is firmly based on medical history, listed symptoms, and decision out other causes. The most common categories of migraines are those without aura (formerly known as common migraines) and those with aura (formerly known as classic migraines).

This can start in childhood or not occur until early adulthood. Females are more likely than males to have migraines. Family history is one of the most communal risk factors for migraines.

Types of migraine

There are several types of migraines. The most common are migraines with aura (also known as classic migraine) and migraines without aura (or common migraine).

Other types include:

  • Menstrual migraine: This is when the headache is related to the woman’s period.
  • Silent migraine: This type is also known as acetic migraine. You have aura symptoms without a headache.
  • Vestibular migraine: You have stability problems, vertigo, nausea, and vomiting, with or without a headache. This type typically occurs in people who have a history of motion sickness.
  • Abdominal migraine: Experts don’t know much about this guy. It causes stomach pain, nausea, and vomiting. It often occurs in children and can develop into classic migraine headaches over time.
  • Hemiplegic migraine: You have a brief period of paralysis (hemiplegia) or weakness on one side of the body. You may also feel numbness, dizziness, or vision changes. These symptoms can also be signs of a stroke, so you should seek medical help immediately.
  • Ophthalmic migraine: They are also known as ocular or retinal migraines. They cause short-term, partial, or total loss of vision in one eye, along with a dull pain behind the eye, which can spread to the rest of the head. Seek medical help immediately if you have any vision changes.
  • Migraine with brainstem aura: Dizziness, confusion, or loss of balance can occur before the headache. Pain can affect the back of the head. These symptoms usually start suddenly and may be accompanied by trouble speaking, ringing in the ears, and vomiting. This type of migraine is fully relevant to hormonal changes and mainly attacks young adult women. Again, have a doctor check for these symptoms right away.
  • Migraine state: This basic type of migraine can last more than 72 hours. The pain and nausea are so bad that you may need to go to the hospital. Sometimes medications or drug withdrawal can cause them.
  • Ophthalmoplegic migraine: This causes pain around the eye, including paralysis of the muscles around it. This is a medical emergency because symptoms can also be caused by pressure on the nerves behind the eye or by an aneurysm. Other symptoms include droopy eyelids, double vision, or other vision changes.

Causes of migraine

Researchers have not identified a definitive cause of migraines. However, they have found some funding factors that can trigger the situation. This includes changes in brain chemicals, such as a reduction in stages of the brain chemical serotonin.

Other factors that can trigger a migraine include:

  • Bright lights
  • Severe heat or other extremes in weather
  • Dehydration
  • Changes in barometric pressure
  • Hormonal changes in women, such as fluctuations in estrogen and progesterone during menstruation, pregnancy, or menopause
  • Excess stress
  • Loud sounds
  • Intense physical activity
  • Skip meals
  • Changes in sleep patterns
  • Use of some medications, such as oral contraceptives or nitroglycerin
  • Unusual smells
  • Certain foods
  • Smoking
  • Alcohol consumption
  • Travel

If you experience a migraine, your doctor may ask you to keep a headache diary. Inscription down what you were doing, the foods you ate, and the medications you were taking before your migraine started can help you recognize your triggers. Find out what else could be causing or triggering your migraines.

Risk factors for migraine

Risk factors may include:

Sex: Women have three times more migraines than men.

Years: Most people start having migraines between the ages of 10 and 40. But many women find that their migraines improve or go away after age 50.

Family history: Four out of five people with migraines have other family members who have them. If one of the parents has a history of these types of headaches, their child has a 50% chance of suffering from them. If both parents have them, the risk increases to 75%.

Other medical conditions: Depression, anxiety, bipolar disorder, sleep disorders, and epilepsy can increase your chances.

Symptoms of migraine

Symptoms of migraine include:

  •  The pain normally on one side of the head, but often on both sides
  •  Throbbing or throbbing pain
  •  Sensitivity to light, sound, and sometimes smell and touch
  •  Nausea and vomiting

Diagnosis of migraine

Your physician will ask about your medical history and indications. It can help to keep a journal of your symptoms and any triggers you have noticed. Make a note of:

  • What symptoms you have, including where it hurts
  • How often do you have them?
  • How long they last?
  • Any other family member who has migraines
  • All the medicines and supplements you take, even those over the counter
  • Other medications you remember taking in the past

Your physician may order checks to rule out other things that could cause your symptoms, including:

  • Blood test
  • Imaging tests such as MRIs or CT scans
  • Electroencephalogram (EEG)

Treatment for migraine

There is no cure for migraines. But many medications can treat or even prevent them. Common treatments for migraine include:

  • Pain relief. Over-the-counter (OTC) medications often work well. The main ingredients are acetaminophen (Panadol, Tylenol), aspirin (Bayer, Bufferin), caffeine, and ibuprofen (Advil, Motrin, Nuprin). Never give aspirin to anyone younger than 19 years old due to the risk of Reye’s syndrome. Be careful when taking over-the-counter pain relievers, because they can also make a headache worse. If you use them too much, you can get rebound headaches or become independent of them. If you take over-the-counter pain relievers more than 2 days a week, talk with your doctor about prescription drugs that might work best. They may suggest prescription medications that may work well to end migraine pain, including triptans as well as newer titans and pants. Your doctor can tell you if these are right for you.
  • Nausea medicine. Your doctor may prescribe medication if you have nausea with a migraine.
  • Triptans. These drugs balance the chemicals in your brain. You may be given a pill to swallow, lozenges to dissolve on the tongue, a nasal spray, or an injection. Samples include almotriptan (Axert), eletriptan (Relpax), sumatriptan (Imitrex), rizatriptan (Maxalt), and zolmitriptan (Zomig).
  • Ergotamine (Cafergot, Migergot, Ergomar), which also acts on chemicals in the brain
  • Lasmiditan (Reyvow). This medicine relieves pain, nausea, and sensitivity to light or sound.
  • CGRP receptor antagonists. Your doctor might prescribe rhyme.

Home remedies

You can ease migraine symptoms by:

  • Rest with your eyes closed in a dark, quiet room.
  • Put a cold pack or ice pack on your forehead
  • Drink a lot of liquids

Complementary and alternative treatments in migraine

Some people get relief from therapies they use in addition to or in place of traditional medical treatment. These are called complementary or alternative treatments. For migraine, they include:

  • Biofeedback. This way helps you take note of stressful situations that could trigger symptoms. If the headache starts slowly, biofeedback can stop the attack before it fully develops.
  • Cognitive-behavioral therapy (CBT). A specialist can teach you how your actions and thoughts affect the way you feel pain.
  • Supplements. Research has established that some vitamins, minerals, and herbs can prevent or treat migraines. These include riboflavin, coenzyme Q10, and melatonin. Butterbur can prevent migraines, but it can also affect liver enzymes.
  • Bodywork. Physical treatments such as chiropractic, massage, acupressure, acupuncture, and craniosacral therapy can relieve headache symptoms.

Talk to your doctor before trying complementary or alternative treatments.


Try these steps to prevent symptoms:

  • Identify and avoid triggers. Keep track of your symptom patterns in a journal so you can find out what is causing them.
  • Manage stress. Relaxation techniques like meditation, yoga, and mindful breathing can help.
  • Eat on a regular schedule
  • Drink lots of fluids
  • Get plenty of rest
  • Get regular moderate exercise

Ask your doctor about preventative medications if you have migraines around your period or if lifestyle changes don’t help.


The International headache society created a system for classifying headaches and migraines and their complications, known as ICHD-3. Some of these include:

Migraine state

This rare and severe migraine with aura lasts more than 72 hours. Some people have been hospitalized due to severe pain.

Migraine infarction

This is when a migraine is associated with a stroke. Usually, this is a migraine with an aura that lasts for more than an hour. Sometimes the aura is present even when the headache goes away. An aura that lasts for more than an hour can be a sign of bleeding in the brain. If you have a migraine with an aura that lasts above an hour, see your physician right away.

Persistent aura without a heart attack

This complication arises if the aura lasts more than a week after the migraine has ended. This complication has symptoms similar to those of a migraine infarct, but there is no bleeding in the brain. See your doctor immediately for a proper diagnosis.


This is a condition in which a headache triggers an epileptic seizure. Typically, the seizure will occur one hour after a migraine. This condition is rare.

Departments to consult for this condition

  • Department of Neurology