Clinical characteristics of patients with brainstem strokes admitted to a rehabilitation unit

Abstract

Teasell R, Foley N, Doherty T, Finestone H. Clinical characteristics of patients with brainstem stroke admitted to a rehabilitation unit. Arch Phys Med Rehabil 2002;83:1013-6. Objective: To examine the clinical characteristics of patients with brainstem strokes admitted to a rehabilitation unit. Design: Retrospective cohort. Setting: Inpatient rehabilitation unit. Participants: 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. Interventions: Not applicable. Main Outcome Measures: 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. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of physical Medicine and Rehabilitation