Brain Stem Strokes

Posted By  CCF NEUROSURGERY MD on September 02, 1997 at 14:20:56:

In Reply to: Brain Stem Strokes posted by Patty on September 02, 1997 at 04:51:51:

: My Father had Bypass Surgery and suffered a stroke 1 month afterwards.
  He had a blood clot form in his vertebral artery.  This caused damage to
  his brain stem and also other parts of his brain.  He lost use of his right
  side, speech, and the gag reflex.  It is now 2 1/2 months later and he
  recovered some movement to his limbs and is being introduced to foods.
  He speech is now enough to understand him.  At this point we are happy
  for this amount of recovery, but we are concerned about his child-like
  behaviors that he does.  He will play with the T.V. buttons and when we
  tell him to stop before he breaks it, then he laughs at us.  He is also very
  impulsive in regards to safety precautions.  His memory and mind seems
  to be there, but is this normal to behave like a child when a brain stem
  stroke occurs?  Should we be concerned that he will always be this way
  any never be able to be left alone?  I would appreciate your response.

[CCF NEUROSURGERY MD]

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Dear Patty,
Unfortunately strokes can occur after bypass surgery in some patients.  
The brainstem stroke that your father suffered would clearly account for
the weakness on the right, the swallowing difficulties, and likely the speech
difficulties.  These symptoms are consistent with the vascular distribution
of the vertebral and basilar arteries.  Recovery from these strokes can be
painfully slow and function may return depending on the severity of the
stroke.
The other symptoms you described, the speech difficulty and the personality
changes, may be due to strokes in other areas of the brain.  In particular,
the personality changes may be due to another stroke, or strokes, in the
frontal lobe area.  This area is fed by branches of the internal carotid
artery.  This is distinct from the arteries named above.  The speech problems
may or may not be due to the brainstem stroke, as there are different kinds
of speech difficulties that a patient may have.
In short, your father may have had more than just the brainstem stroke.
The best course of action would be to ask your neurologist's opinion after
a complete neurological examination and review of the CT's or MRI's that
were done.  A better estimate of prognosis can be made at that time.
We hope your father continues to improve.
Good luck.