Clinical characteristics of patients with brainstem strokes admitted to a rehabilitation unit.
OBJECTIVE
To examine the clinical characteristics of patients with brainstem strokes admitted to a rehabilitation unit.


METHODS
Retrospective cohort.


METHODS
Inpatient rehabilitation unit.


METHODS
Eighty-five consecutive admissions (56 men, 29 women; mean age, 61.9+/-14.4y; range, 18-85y) with radiologically confirmed focal evidence of specific lesions within the pons, midbrain, cerebellum, and medulla.


METHODS
Not applicable.


METHODS
Various clinical characteristics, including stroke-related deficits and stroke risk factors, were identified and compared between brainstem subgroups. The incidence of complications, including pneumonia, deep vein thrombosis, and seizure disorder, was also reported.


RESULTS
Seventy (82%) of the strokes resulted from infarctions and 15 (18%) were caused by hemorrhages. The functional deficits of hemiparesis, ataxia, and diplopia were present in 41 (48%), 73 (86%), and 32 (38%) patients, respectively. Dysarthria was reported in 42 patients (49%) and dysphagia in 40 (47%). Pneumonia during hospitalization was a complication in 9 (11%) of the patients with brainstem stroke. The risk factors of diabetes and hypertension were present in 22 (26%) and 47 (55%) patients, respectively. Fourteen (17%) of these patients had suffered a previous stroke.


CONCLUSIONS
Rehabilitation patients experience a variety of functional impairments as a consequence of brainstem stroke. These include hemiparesis, dysarthria and dysphagia, diplopia, and ataxia. A significant number of patients had pneumonia as a complication. The characteristics and impairment profiles of patients within the subgroups were similar, with the exception of the incidence of ataxia and hemiparesis.
Teasell
Robert
R
Department of Physical Medicine and Rehabilitation, St Joseph's Health Care, London, Ont, Canada. robertteasell@sjhc.london.on.ca
Foley
Norine
N
Doherty
Timothy
T
Finestone
Hillel
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001933:Brain Stem / Q000000981:diagnostic imaging; D020526:Brain Stem Infarctions / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000534:rehabilitation*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000534:rehabilitation*; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000453:epidemiology; D011014:Pneumonia / Q000453:epidemiology; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D020246:Venous Thrombosis / Q000453:epidemiology