Table of ContentsView AllTable of ContentsLocationMedullary Stroke EffectsSymptomsRisk FactorsDiagnosisRecovery
Table of ContentsView All
View All
Table of Contents
Location
Medullary Stroke Effects
Symptoms
Risk Factors
Diagnosis
Recovery
A stroke in the medulla oblongata, also known as a medullary stroke, is a rare type of stroke that affects themedulla oblongata, a structure in the brain that transfers nerve messages to thespinal cord.Although rare, medullary strokes are fatal in about 11% of cases. The risk of medullary stroke is highest in people ages 65 and up, and those witharterial disease.
Vertigo, double vision, facial and limb paralysis, and loss of coordination are some of the most common medullary stroke symptoms.The faster you get medical attention for a stroke, the better your chances are of survival. If you are experiencingstroke symptoms, call 911 or get to an emergency room immediately.
This article explains what the medulla oblongata is along with the causes and symptoms of medullary stroke. It also covers how this type of stroke is diagnosed and treated.
Encyclopaedia Britannica / Getty Images
What Is the Medulla Oblongata?
Thebrainstemis the stalk-like feature located at the base of the brain. It is comprised of three sections: themidbrain,pons, and medulla oblongata. The medulla, which sits at the bottom-most part of the brainstem, connects to the spinal cord.
The medulla oblongata is densely packed with nerves that serve a variety of purposes. Some carry sensory information between the brain and spinal cord. Others coordinate various reflexes andautonomic functionsthat are essential for life.
Function of the Medulla Oblongata
The medulla oblongata is also your brain’s reflex control center. It is responsible for activating such reflexes as:
Effects of a Medullary Stroke
A stroke of the medulla interferes with vital nerve messages. It can result in a number of serious problems, such as:
A stroke involving the medulla can also interfere with your body’s normal breathing, heart function, and other vital autonomic functions. Some people who have this type of stroke may need a machine to breathe.
More severe strokes in the medulla can cause “locked-in syndrome.“This is a condition in which people are conscious but cannot move any part of the body except the eyes.
Symptoms of Medullary Stroke
Stroke symptoms can be hard to recognize. A stroke of the brainstem and medulla may at first cause vague symptoms, such as headaches and dizziness.The symptoms can worsen, however, and the stroke may progress rapidly.
Some of the symptoms of a medullary stroke include:
A medullary stroke can cause numbness and sensory problems on one side of the body, and weakness on the opposite side. This is unusual because most other strokes cause sensory problems and weakness on the same side of the body.
There are long nerve pathways that transmit information between the body and the brain. Many of these pathways cross over to the opposite side in the medulla. This causes the unique pattern of symptoms characteristic of medullary stroke.
Is an Injury to the Medulla Oblongata Fatal?Not always. Some injuries to this part of the brain cause problems like numbness, poor motor control, and paralysis. Because the medulla controls critical involuntary functions like heartbeat and breathing, however, some medullary strokes can be fatal.
Is an Injury to the Medulla Oblongata Fatal?
Not always. Some injuries to this part of the brain cause problems like numbness, poor motor control, and paralysis. Because the medulla controls critical involuntary functions like heartbeat and breathing, however, some medullary strokes can be fatal.
Risk factors for a medullary stroke are the same as the risk factors for strokes in other areas of the brain. They include:
It is also possible for a medullary stroke to happen after a sudden head or neck movement injures an artery. This is rare, however.
A stroke in the medulla can be more difficult to diagnose than other strokes. This is because symptoms like dizziness, balance problems, and headaches are vague. Usually, aneurologistcan identify a medullary stroke during a physical examination. If the symptoms are mild, however, they might not be very apparent in the early stages.
A brainCT scanor a brainMRIcan also be used to diagnose a medullary stroke. A brain MRI is usually considered a reliable test for identifying strokes in this part of the brain.
If there is concern about blood vessels or blood flow, an ultrasound orangiogrammay help healthcare providers observe the blood vessels. An ultrasound uses sound waves to visualize internal structures. An angiogram uses X-rays to track how blood moves through the body.
How Stroke Is Diagnosed
Recovering From a Medullary Stroke
Recovery from a medullary stroke depends on the size of the stroke and how quickly you were treated.Your rate of healingalso plays an important role.
Strokes of the medulla oblongata do not affect the language or thinking areas of the brain. This can make it easier for you to participate more fully in yourrehabilitation.
Stroke Treatment: Before, During, and After
Summary
A medullary stroke happens in the medulla oblongata, which is located on the brain stem. This part of your brain transfers messages from the brain to the spinal cord and is responsible for many of your body’s involuntary functions.
A medullary stroke can cause serious symptoms like paralysis and coordination problems. In severe cases, patients may need a machine to breathe.
Symptoms can be vague at first but may progress to numbness, weakness, and loss of balance. An MRI can help your healthcare provider diagnose this type of stroke.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Diek D, Smidt M, Mesman S.Molecular organization and patterning of the medulla oblongata in health and disease.Int J Mol Sci. 2022 Aug;23(16):9260. doi:10.3390/ijms23169260Zhang DP, Liu XZ, Yin S, et al.Risk factors for long-term death after medullary infarction: A multicenter follow-up study.Front Neurol. 2021 Mar;12(1):615230. doi:10.3389/fneur.2021.615230Muhammad A, Ali L, Hussain S, et al.An in-depth analysis of the medullary strokes at a tertiary care stroke center: Incidence, clinical, radiological characteristics, etiology, treatment, and prognosis.Cureus. 2023 Aug;15(8):e43017. doi:10.7759/cureus.43017Benghanem S, Mazeraud A, Azabou E, et al.Brainstem dysfunction in critically ill patients.Crit Care. 2020 Jan;24(1):5. doi:10.1186/s13054-019-2718-9Ludwig R, Welch M.Wired to connect: The autonomic socioemotional reflex arc.Front Psychol. 2022 Jun;13(1):1-19. doi:10.3389/fpsyg.2022.841207Kim K, Lee HS, Jung YH, et al.Mechanism of medullary infarction based on arterial territory involvement.J Clin Neurol. 2012;8(2):116-22. doi:10.3988/jcn.2012.8.2.116Sarà M, Cornia R, Conson M, Carolei A, Sacco S, Pistoia F.Cortical brain changes in patients with locked-in syndrome experiencing hallucinations and delusions.Front Neurol. 2018;9:354. doi:10.3389/fneur.2018.00354Choi JH, Kim HW, Choi KD, et al.Isolated vestibular syndrome in posterior circulation stroke: frequency and involved structures.Neurol Clin Pract. 2014;4(5):410-418. doi:10.1212/CPJ.0000000000000028Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS.Lateral medullary infarction with or without extra-lateral medullary lesions: what is the difference?.Cerebrovasc Dis. 2018;45(3-4):132-140. doi:10.1159/000487672Lee EJ, Choo IY, HA SY, Kwon HM.Medullary infarction presenting as sudden cardiac arrest: report of two cases and review of the literature.J Korean Neurol Assoc. 2018:310-3. doi:10.17340/jkna.2018.4.6Boehme AK, Esenwa C, Elkind MS.Stroke risk factors, genetics, and prevention.Circ Res. 2017;120(3):472-495. doi:10.1161/CIRCRESAHA.116.308398Fu X, Lu Z, Wang Y, et al.A clinical research study of cognitive dysfunction and affective impairment after isolated brainstem stroke.Front Aging Neurosci. 2017;9:400. doi:10.3389%2Ffnagi.2017.00400Additional ReadingKim JS, Caplan LR.Clinical stroke syndromes.Front Neurol Neurosci. 2016;40:72-92. doi:10.1159/000448303
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Diek D, Smidt M, Mesman S.Molecular organization and patterning of the medulla oblongata in health and disease.Int J Mol Sci. 2022 Aug;23(16):9260. doi:10.3390/ijms23169260Zhang DP, Liu XZ, Yin S, et al.Risk factors for long-term death after medullary infarction: A multicenter follow-up study.Front Neurol. 2021 Mar;12(1):615230. doi:10.3389/fneur.2021.615230Muhammad A, Ali L, Hussain S, et al.An in-depth analysis of the medullary strokes at a tertiary care stroke center: Incidence, clinical, radiological characteristics, etiology, treatment, and prognosis.Cureus. 2023 Aug;15(8):e43017. doi:10.7759/cureus.43017Benghanem S, Mazeraud A, Azabou E, et al.Brainstem dysfunction in critically ill patients.Crit Care. 2020 Jan;24(1):5. doi:10.1186/s13054-019-2718-9Ludwig R, Welch M.Wired to connect: The autonomic socioemotional reflex arc.Front Psychol. 2022 Jun;13(1):1-19. doi:10.3389/fpsyg.2022.841207Kim K, Lee HS, Jung YH, et al.Mechanism of medullary infarction based on arterial territory involvement.J Clin Neurol. 2012;8(2):116-22. doi:10.3988/jcn.2012.8.2.116Sarà M, Cornia R, Conson M, Carolei A, Sacco S, Pistoia F.Cortical brain changes in patients with locked-in syndrome experiencing hallucinations and delusions.Front Neurol. 2018;9:354. doi:10.3389/fneur.2018.00354Choi JH, Kim HW, Choi KD, et al.Isolated vestibular syndrome in posterior circulation stroke: frequency and involved structures.Neurol Clin Pract. 2014;4(5):410-418. doi:10.1212/CPJ.0000000000000028Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS.Lateral medullary infarction with or without extra-lateral medullary lesions: what is the difference?.Cerebrovasc Dis. 2018;45(3-4):132-140. doi:10.1159/000487672Lee EJ, Choo IY, HA SY, Kwon HM.Medullary infarction presenting as sudden cardiac arrest: report of two cases and review of the literature.J Korean Neurol Assoc. 2018:310-3. doi:10.17340/jkna.2018.4.6Boehme AK, Esenwa C, Elkind MS.Stroke risk factors, genetics, and prevention.Circ Res. 2017;120(3):472-495. doi:10.1161/CIRCRESAHA.116.308398Fu X, Lu Z, Wang Y, et al.A clinical research study of cognitive dysfunction and affective impairment after isolated brainstem stroke.Front Aging Neurosci. 2017;9:400. doi:10.3389%2Ffnagi.2017.00400Additional ReadingKim JS, Caplan LR.Clinical stroke syndromes.Front Neurol Neurosci. 2016;40:72-92. doi:10.1159/000448303
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Diek D, Smidt M, Mesman S.Molecular organization and patterning of the medulla oblongata in health and disease.Int J Mol Sci. 2022 Aug;23(16):9260. doi:10.3390/ijms23169260Zhang DP, Liu XZ, Yin S, et al.Risk factors for long-term death after medullary infarction: A multicenter follow-up study.Front Neurol. 2021 Mar;12(1):615230. doi:10.3389/fneur.2021.615230Muhammad A, Ali L, Hussain S, et al.An in-depth analysis of the medullary strokes at a tertiary care stroke center: Incidence, clinical, radiological characteristics, etiology, treatment, and prognosis.Cureus. 2023 Aug;15(8):e43017. doi:10.7759/cureus.43017Benghanem S, Mazeraud A, Azabou E, et al.Brainstem dysfunction in critically ill patients.Crit Care. 2020 Jan;24(1):5. doi:10.1186/s13054-019-2718-9Ludwig R, Welch M.Wired to connect: The autonomic socioemotional reflex arc.Front Psychol. 2022 Jun;13(1):1-19. doi:10.3389/fpsyg.2022.841207Kim K, Lee HS, Jung YH, et al.Mechanism of medullary infarction based on arterial territory involvement.J Clin Neurol. 2012;8(2):116-22. doi:10.3988/jcn.2012.8.2.116Sarà M, Cornia R, Conson M, Carolei A, Sacco S, Pistoia F.Cortical brain changes in patients with locked-in syndrome experiencing hallucinations and delusions.Front Neurol. 2018;9:354. doi:10.3389/fneur.2018.00354Choi JH, Kim HW, Choi KD, et al.Isolated vestibular syndrome in posterior circulation stroke: frequency and involved structures.Neurol Clin Pract. 2014;4(5):410-418. doi:10.1212/CPJ.0000000000000028Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS.Lateral medullary infarction with or without extra-lateral medullary lesions: what is the difference?.Cerebrovasc Dis. 2018;45(3-4):132-140. doi:10.1159/000487672Lee EJ, Choo IY, HA SY, Kwon HM.Medullary infarction presenting as sudden cardiac arrest: report of two cases and review of the literature.J Korean Neurol Assoc. 2018:310-3. doi:10.17340/jkna.2018.4.6Boehme AK, Esenwa C, Elkind MS.Stroke risk factors, genetics, and prevention.Circ Res. 2017;120(3):472-495. doi:10.1161/CIRCRESAHA.116.308398Fu X, Lu Z, Wang Y, et al.A clinical research study of cognitive dysfunction and affective impairment after isolated brainstem stroke.Front Aging Neurosci. 2017;9:400. doi:10.3389%2Ffnagi.2017.00400
Diek D, Smidt M, Mesman S.Molecular organization and patterning of the medulla oblongata in health and disease.Int J Mol Sci. 2022 Aug;23(16):9260. doi:10.3390/ijms23169260
Zhang DP, Liu XZ, Yin S, et al.Risk factors for long-term death after medullary infarction: A multicenter follow-up study.Front Neurol. 2021 Mar;12(1):615230. doi:10.3389/fneur.2021.615230
Muhammad A, Ali L, Hussain S, et al.An in-depth analysis of the medullary strokes at a tertiary care stroke center: Incidence, clinical, radiological characteristics, etiology, treatment, and prognosis.Cureus. 2023 Aug;15(8):e43017. doi:10.7759/cureus.43017
Benghanem S, Mazeraud A, Azabou E, et al.Brainstem dysfunction in critically ill patients.Crit Care. 2020 Jan;24(1):5. doi:10.1186/s13054-019-2718-9
Ludwig R, Welch M.Wired to connect: The autonomic socioemotional reflex arc.Front Psychol. 2022 Jun;13(1):1-19. doi:10.3389/fpsyg.2022.841207
Kim K, Lee HS, Jung YH, et al.Mechanism of medullary infarction based on arterial territory involvement.J Clin Neurol. 2012;8(2):116-22. doi:10.3988/jcn.2012.8.2.116
Sarà M, Cornia R, Conson M, Carolei A, Sacco S, Pistoia F.Cortical brain changes in patients with locked-in syndrome experiencing hallucinations and delusions.Front Neurol. 2018;9:354. doi:10.3389/fneur.2018.00354
Choi JH, Kim HW, Choi KD, et al.Isolated vestibular syndrome in posterior circulation stroke: frequency and involved structures.Neurol Clin Pract. 2014;4(5):410-418. doi:10.1212/CPJ.0000000000000028
Kang HG, Kim BJ, Lee SH, Kang DW, Kwon SU, Kim JS.Lateral medullary infarction with or without extra-lateral medullary lesions: what is the difference?.Cerebrovasc Dis. 2018;45(3-4):132-140. doi:10.1159/000487672
Lee EJ, Choo IY, HA SY, Kwon HM.Medullary infarction presenting as sudden cardiac arrest: report of two cases and review of the literature.J Korean Neurol Assoc. 2018:310-3. doi:10.17340/jkna.2018.4.6
Boehme AK, Esenwa C, Elkind MS.Stroke risk factors, genetics, and prevention.Circ Res. 2017;120(3):472-495. doi:10.1161/CIRCRESAHA.116.308398
Fu X, Lu Z, Wang Y, et al.A clinical research study of cognitive dysfunction and affective impairment after isolated brainstem stroke.Front Aging Neurosci. 2017;9:400. doi:10.3389%2Ffnagi.2017.00400
Kim JS, Caplan LR.Clinical stroke syndromes.Front Neurol Neurosci. 2016;40:72-92. doi:10.1159/000448303
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