Signs of brain stem damage

Introduction The brain stem contains not only most of the cranial nerve nucleus (except the olfactory nerve and the optic nerve), but also the whole body sensation and the motor conduction beam pass through the brainstem. The respiratory circulatory center is also located here, and the brainstem reticular structure is important for participating in the maintenance of consciousness. structure. Therefore, after brain stem injury, in addition to the performance of local cranial nerve damage, the disturbance of consciousness and motor dysfunction is often severe, and there may be failure of respiratory and circulatory function, which is life-threatening, and has increased significantly in recent years. Younger development.

Cause

Primary brain stem hemorrhage, violent action on the head caused by primary brain stem damage, brain stem infarction (vertebral basilar artery and its branches have atherosclerosis, or arterial embolism, spasm, inflammation leading to stenosis, ischemia Caused by circulatory disorders, including cerebral thrombosis, cerebral embolism, etc., cerebral infarction accounted for 70% to 80% of all strokes, has increased significantly in recent years, and is developing younger. Some patients are only 27 years old, but most of them For middle-aged and older people over 45 years old.

an examination

Related inspection

Brain CT examination brain MRI examination EEG examination brain nerve examination

Primary brain stem injury often coincides with other brain injury. The clinical symptoms overlap and the differential diagnosis is more difficult. The diagnosis of primary brain stem injury is basically established in patients who are comatose and progressively aggravated immediately after injury, with variable pupil size, early respiratory failure, and presence of cortical rigidity and bilateral pathological signs. Generally check platelet aggregation rate, coagulation function, blood sugar, blood lipid level, liver and kidney function, etc.; electrocardiogram, chest radiograph. These tests help to clarify the patient's basic condition, and some of the results also help to determine the cause. Special examinations include brain structure imaging assessment, cerebrovascular imaging assessment, brain perfusion and functional examination.

Differential diagnosis

Primary brain stem injury is often accompanied by brain contusion or intracranial hemorrhage, and the clinical symptoms are mutually wrong. It is difficult to distinguish between phlegm and blood stasis, and which is the main one. Especially for patients who are late in treatment, it is more difficult to distinguish the primary. Sexual injury or secondary damage. The difference between primary brain stem injury and secondary brain stem injury is the presence of symptoms and signs.

Continuous monitoring of intracranial pressure can also be identified: primary intracranial pressure is not high and secondary is significantly elevated. At the same time, CT and MRI are also effective means of differential diagnosis. In the display of small hemorrhagic foci or contusion in the brain parenchyma, especially the health search is a minor damage to the corpus callosum and brainstem, MRI is significantly better than CT.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.