Auto accidents impose tremendous trauma on the body, but one of the most catastrophic categories of injury is brain injury. Your brain is the control center of your body, and even relatively minor damage can be irreparable.
According to the U.S. Centers for Disease Control and Prevention (CDC), nearly 300,000 people suffer concussions each year as a result of car accidents. While all brain injuries are serious, concussions are considered to be on the milder end of the spectrum. In fact, the National Institutes of Health (NIH) reports that approximately 75% of all traumatic brain injuries (TBIs) are classified as mild.
On the other end of the spectrum are injuries like brain stem injuries. Damage to the brain stem is always catastrophic. In this guide, we discuss these types of injuries, how they’re diagnosed, and what the future holds if you’re diagnosed with brain stem damage.
Key Takeaways
- The brain stem is a stalk-like structure that connects the brain and spinal cord together as part of normal brain function.
- Your brain stem is a primary communication pathway between the brain and the rest of the body, with it playing a vital role in everything from breathing to regulating your heart rate and blood pressure.
- A brain stem injury may originate from a car accident, a fall, or high-impact sports. The shearing forces caused by the brain suddenly shifting inside the skull are responsible for these injuries, but certain medical conditions, like cancer tumors, may also damage the brain stem.
- Symptoms of brain stem injuries include, but are not limited to, loss of consciousness, balance issues, lack of coordination, dizziness, nausea, vomiting, and difficulty with essential functions such as breathing, swallowing, and speaking.
- Diagnosis and treatment of brain stem injuries are highly individualized, with medications, surgery, and physical rehabilitation all part of a potential treatment plan.
- If your brain stem injury resulted from someone else’s negligence, you have the right to seek compensation as part of a financial settlement. The best way to deal with this is to consult a car accident injury lawyer who can file your case and assert your right to compensation.
The Brain Stem: Anatomy and Function
Your brain stem is the structure that connects your brain to the spinal cord. Severely damaged and severed brain stems are nearly always fatal because they’re what connects your brain to the rest of the body. Without it, you can’t control and maintain even the most basic functions, including breathing and heart rate.
What is the Brain Stem, and Where Is It Located?
The brain stem connects the cerebrum of your brain to your spinal cord. It consists of the midbrain, pons, and medulla oblongata. It resembles a stalk-like structure and it’s connected to the base of your brain, which is just above the spinal cord.
It’s perhaps the most critical communication channel your body has, which is why brain stem injuries are so catastrophic. The CDC doesn’t maintain figures on brain stem injuries, but 210,000 people are hospitalized due to brain injuries each year.
Vital Functions Controlled by the Brain Stem
The brainstem controls just about all essential life functions your body has. It operates without conscious effort and essentially keeps you alive.
The main essential body functions that the brain stem is fundamental to controlling and maintaining include:
- Breathing
- Heart rate
- Blood pressure
- Sleep
- Swallowing
- Reflexes
- Balance
- Coordination
Most of the nerves responsible for controlling the motor and sensory functions in your face and neck are also housed inside the brain stem.
Why the Brain Stem is Especially Vulnerable in Auto Accidents
Your brain stem is especially vulnerable in auto accidents because of its location and the most common trauma points when the head, neck, and spine are found within serious car accidents. Any rapid, sudden movements of the head and neck cause your brain to shift inside the skull. The knock-on effect means your brain stem can be damaged if the shearing forces are significant enough.
Each year, 50,000 people die from TBIs. A third of these are trauma-related, according to TreatNOW. If we look at the global picture, a National Institutes of Health study estimates that 70% of all roadside fatalities are caused by a head injury.
Brain stem injuries are always severe, which is why PubMed reports that 16% of head injuries categorized as severe involve the brain stem.
Causes of Brain Stem Injuries
Brain stem injuries can arise from traumatic injuries, but also from medical conditions that impair its ability to function correctly. Unfortunately, like the rest of the brain, for such a crucial part of the body, it’s also incredibly fragile.
Let’s go through some of the primary causes of these injuries.
Traumatic Causes: Auto Accidents, Falls, and Sports Injuries
Traumatic brainstem injuries are classified as injuries resulting from external mechanical forces. What all these injuries have in common is that the brain moves inside the skull, and the shearing forces damage the brain.
The National Center for Biotechnology Information lists the following primary traumatic causes:
- Car accidents
- Falls
- Sports injuries
Any high-impact situation works the same way. The sudden acceleration and deceleration forces result in the brain slamming into the inside of your skull. Whether it’s a high-impact sport like football or boxing, a car accident, or a fall from a significant height or onto a hard surface, the brain stem is at risk.
Non-Traumatic Causes: Stroke, Tumors, and Infections
Not all brainstem injuries result from mechanical forces. Medical conditions can impact the brain and brain stem in ways that impair function through tissue damage. Here are three examples of how medical conditions can cause brain stem injuries in different ways:
- Stroke – Ischemic strokes can reduce blood flow to the brain and brain stem, leading to tissue damage and a condition called brain death.
- Tumors – Benign and malignant brain tumors can put pressure on the sensitive brain stem itself. These constrictions disrupt function and may even result in permanent damage.
- Infections – Certain types of infections may spread and cause inflammation in the brain stem, which might damage connections between your neurons or disrupt their normal functions.
Typically, the longer a person waits for medical intervention with these types of conditions, the greater the risk of permanent damage.
The Role of Oxygen Deprivation in Brain Stem Damage
Your brain relies on a constant flow of oxygen to function. Oxygen deprivation, whether intentional or not, disrupts energy production inside individual cells. Without energy, your brain cells can’t function, which means your body can’t function.
The obvious example is cardiac arrest, otherwise known as a heart attack, when a blood clot closes off your blood vessels. When your heart isn’t pumping correctly, oxygenated red blood cells aren’t making it to your brain, which stops its ability to function.
Likewise, drowning, choking, and other forms of suffocation prevent your lungs from functioning, meaning your oxygen supply isn’t making it to your other organs, including the brain. Eventually, the cells in your brain and brain stem will simply die.
Recognizing the Symptoms of Brain Stem Injury
Brain stem injury symptoms have notable calling cards, allowing you to notice immediately when there’s a problem. Recognizing these symptoms is crucial for seeking medical attention because the quicker you get treatment, the more of a person you save.
Initial Symptoms to Watch For
Brain stem injuries manifest immediately, with a range of symptoms providing the red flags needed to seek medical attention at your nearest emergency room.
Here are the initial symptoms to look out for:
- Loss of consciousness
- Dizziness
- Balance issues
- Nausea/vomiting
- Slurred speech
- Abnormal eye movements
These symptoms usually have massive variations in severity. For example, someone may experience a brief fainting spell or enter into a minimally conscious state. Either way, even the most minor episodes indicate damage to the brain stem.
Neurological Symptoms: Coordination, Consciousness, and Sensory Impairments
Initial symptoms are usually physical in nature, but as the injury plays out, you’ll start to notice neurological problems. This is often when any form of brain damage becomes apparent to accident victims and their loved ones.
Examples include:
- Problems with fine motor skills.
- Unable to maintain balance.
- Fluctuations in alertness.
- Altered and lost senses.
- Difficulty swallowing
- Vocal changes
- Facial muscle weakness
These symptoms arise because the brain stem coordinates your motor functions while integrating sensory information from the world around you.
Impact on Respiratory and Cardiovascular Functions
Without the brain stem, you can’t breathe or manage your heart. Due to its role in the critical autonomic functions of the body, some of the other symptoms you might see include irregular breathing patterns, unstable heart rates, and blood pressure.
Some brain stem injuries also lead to neurological disorders like dysautonomia, which is a disorder affecting the autonomic nervous system, causing dysfunction throughout the whole body.
Regardless of how your injury manifests itself, any issue with your respiratory and cardiovascular functions is life-threatening.
Long-Term Effects and Complications
Surviving a brain stem injury will usually mean lasting effects that alter your quality of life. These catastrophic injuries cannot be reliably repaired, meaning that there’s very little chance of you reclaiming your original quality of life after being diagnosed with this injury.
Practically all TBIs can have lasting complications. According to the CDC, moderate to severe TBIs reduce life expectancy by an average of nine years. Additionally, CBS News reported that someone with a TBI is three times more likely to die before their 56th birthday.
Physical Impairments: Motor Skills and Coordination Issues
Long-term physical impairments are a typical outcome of a brain stem injury. You might experience persistent muscle weakness, loss of mobility, and even involuntary movements. Unfortunately, this also translates to a complete loss of control of bodily movements, which is a condition known as ataxia.
Physical therapy and rehabilitation may be able to help, but your prognosis depends on how severe the brain stem injury was.
Cognitive Changes: Memory, Attention, and Processing Deficits
Naturally, you’ll notice some changes in how your mind functions. Even if the bulk of your brain is fine, the brain stem’s role in acting as a channel between the brain and the rest of your body means that cognitive changes reduce your quality of life.
Survivors often experience:
- Inability to focus.
- Difficulty recalling recent events.
- Trouble learning new information.
- Taking longer to understand information.
- Problems organizing and executing day-to-day tasks.
All of these issues impact every aspect of your life. Cognitive rehabilitation strategies may mitigate symptoms, but there’s no long-term cure.
Emotional and Behavioral Changes Following Brain Stem Injury
Loved ones often note that survivors change after brain stem injuries. They’re often not the same people, with their behaviors and personalities making them challenging to deal with. It’s not their fault, but the damage to the brain means that mood swings, depression, irritability, and aggression aren’t uncommon symptoms.
According to Harvard Medical School, many people with brain injuries often enter into phases of social withdrawal. They actively avoid social interactions and activities, essentially making them hermits.
Diagnosing Brain Stem Injuries
Medical science has come a long way, and it allows professionals to accurately diagnose brain stem injuries better than ever before. With clinical evaluations, MRIs, CT scans, and electrophysiological tests, diagnosis times have never been faster, enabling accident victims to receive the treatment they desperately need.
Clinical Evaluation and Neurological Examination Techniques
Diagnosing a brain stem injury is a multi-stage process, but it all starts with an in-depth neurological evaluation. One of the most common tools is the Glasgow Coma Scale (GCS), which assesses motor, verbal, and eye responses to determine the severity of the injury.
Plus, doctors may perform specific tests focusing on cranial nerve function. They’ll check aspects like:
- Facial symmetry
- Eye movements
- Pupil reactions
- Gag reflex
These tests aren’t just designed to diagnose a brain stem injury but also to localize it to get a better idea of the different treatment options.
Imaging Studies: MRI and CT Scans in Diagnosis
Imaging studies help to visualize the damage to the brain stem itself. MRI and CT scans form the basis of these imaging examinations. The first imaging option is usually a CT scan because it’s the best way to detect brain swelling, bleeding, and fractures.
MRI scans offer more detailed images of the brain tissue, capable of detecting everything from small lesions to non-hemorrhagic injuries. Occasionally, a doctor might also order a Diffusion-Weighted Imaging (DWI), which is a more advanced version of an MRI.
Electrophysiological Tests: Understanding Brain Activity
Imaging offers a snapshot of any potential damage, but measuring the electrical activity of the brain and your body’s nervous system offers a functional look into a potential brain stem injury. These types of tests include:
- Electroencephalography (EEG) – EEG scans look at the brain’s electrical activity to determine brain dysfunction severity and detect seizures. They’re often used on patients in comas.
- Evoked Potentials (EPs) – EPs measure how the brain reacts to different stimuli, such as measuring the sensory pathways or the integrity of the auditory pathways through the brain stem. Any abnormalities in these tests can localize the damage in the brainstem.
Electrophysiological tests complement imaging tests. Additionally, imaging isn’t perfect, and the results of these tests can offer valuable insights when imaging either misses something or is inconclusive.
Treatment and Rehabilitation Options
Treating brain injuries is always a problem because many brain injuries can’t be healed fully. Sometimes, there may be no viable option at all. However, science has come a long way, meaning there’s more hope for victims of brain injuries than ever.
Typically, clinicians explore multiple options, including medications, surgery, and cognitive therapies, to give patients the best possible outcome.
Emergency Care: Immediate Interventions and Stabilization
Time is of the essence when a patient presents with a suspected brain stem injury. Initially, the focus is on preventing additional damage and stabilizing the patient to save their life. This will include clearing the airways, monitoring and maintaining blood pressure, controlling pressure on the cranium, and preventing seizures via anticonvulsants.
Rehabilitation Strategies: Physical, Occupational, and Speech Therapy
After a patient has been stabilized, the focus shifts to helping patients regain lost functions. Typically, this will begin with physical therapy to help improve their mobility and balance. It will also include speech therapy, where patients relearn how to speak and communicate. These exercises often focus on developing muscle strength and coordination.
At some stage, therapists will move to support patients in regaining their independence. This is known as occupational therapy and supports patients as they learn to perform basic tasks in their day-to-day life, including bathing, eating, and dressing.
Of course, the success of this multidisciplinary approach largely depends on the extent of the injury. The goal is to set realistic targets based on their long-term diagnosis.
Medications and Surgical Interventions for Symptom Relief
How medications are used largely depends on the patient. If the patient is in sufficient condition, they may be prescribed medications to help them manage the lasting symptoms of their brain stem injury.
For example, they may receive pain medications to manage chronic pain or antidepressants to deal with the mental health complications.
If there’s swelling, bleeding, or certain types of structural damage, surgery may be necessary to save a patient’s life. According to UC Health, this may take the form of relieving pressure on the brain or repairing those injuries that can be repaired.
Innovative Therapies and Technologies in Brain Rehabilitation
Brain rehabilitation is one of the most complex types of rehabilitation there is. Emerging therapies and technologies are helping patients accelerate their recovery journeys and also improve the results.
Here are some of the innovations that are already changing the approach to brain rehabilitation:
- Robotic-Assisted Therapy – Robots are becoming increasingly common to provide patients with more practice in repetitive movements. Studies have already shown a faster rate of motor recovery when robotic-assisted therapy is used.
- Virtual Reality (VR) Therapy – The more practice a patient gets in diverse environments, the more results they’re likely to see. VR headsets allow patients to use controlled settings to practice real-world tests in a way that’s safe and secure.
- Transcranial Magnetic Stimulation (TMS) – TMS has been viewed as one of the finest alternatives to surgery. It’s a non-invasive technique that relies on magnetic fields to stimulate nerve cells and improve motor function.
The goal of these therapies isn’t to replace traditional rehabilitation options but to complement them. All patients react differently, and extra options enhance their chances of making strides in their recoveries.
The Road to Recovery
When we talk about recovery in a brain stem injury context, we’re talking about the best possible outcome. Unlike other injuries, brain stem patients often don’t recover 100% because of the nature of their injuries.
Mild brain stem injuries may be treated with rehabilitation and time. Still, more severe injuries are often about compromise, and that’s why patients must set realistic expectations and accept that there are no easy fixes.
Setting Realistic Goals for Rehabilitation After Brain Stem Injury
Every recovery journey is unique, which is why no two patients will go through the same process. According to the Brain Injury Association of America, the best option is for patients to work with their doctors to define goals using the SMART system.
Ideally, these goals will be split into short and long-term goals. Initially, patients may set a goal where they can stand without assistance, whereas a long-term goal could be to walk independently.
The Importance of Support Systems: Family and Caregivers
Care teams play a central role in delivering treatments, but the best possible outcomes come from surrounding oneself with a broad support network, including family members and close friends.
Caregivers must assist with daily activities, but it’s an emotional burden that usually can’t be handled alone. Caregivers themselves must be adequately supported so that they can maintain their own health.
According to a PubMed study, caregivers who receive the proper support provide more effective care, accelerating their patients’ recovery. In short, these support networks and offering support for key members within that support network is a win-win for everybody.
Advances in Rehabilitation Techniques and Technologies in 2025
Rehabilitation technologies are providing hope for individuals who may have never otherwise fully recovered and returned to some semblance of a normal life. But the landscape is changing, and victims of brain stem injuries have more options than ever.
Examples of these innovations include:
- Brain-Computer Interfaces (BCIs) – BCIs have never been more advanced. They allow patients to use these devices to control assistive technology using their own neural signals. There’s also the potential for BCIs to even restore partial and complete movement in people with motor impairments.
- Stem Cell Therapy – Stem cells have been a subject of interest for a long time in treating all manner of injuries. It’s also hoped that stem cells can be used to repair neural damage and restore cognitive function, at least partially.
- Robotic Exoskeletons – Mobility aids are a natural part of the recovery process. A new range of robotic exoskeletons is aiding patients in this manner, with support for muscle strengthening and gait training. Most recently, the FDA has approved the EksoNR exoskeleton for these very purposes.
Legal Considerations for Auto Accident Victims
Auto accident victims with a brain stem injury have the right to seek a settlement for their losses, including medical expenses, lost wages, and future lost earnings capacity. They also have the right to receive compensation for their non-economic damages, including pain and suffering and loss of consortium.
But how do you show that you are entitled to a settlement?
Establishing Liability and Causation in Brain Stem Injury Cases
Personal injury law relies on proving that the other party was negligent and their actions or inactions directly contributed to your injury. This means proving that there was factual causation and proximate causation.
Of course, this essentially means proving that there was a duty of care, a breach of that duty, and that the victim suffered actual losses from the defendant’s actions. Establishing causation can be challenging, which is why the support of an experienced car accident attorney is crucial.
Understanding the Legal Process: From Filing a Claim to Settlement
Dealing with a brain stem injury and trying to deal with the legal process can often seem impossible, which is why the support of family members and a personal injury attorney is essential for ensuring you’re not left out of pocket by someone else’s negligence.
The process usually follows five distinct steps:
- An initial consultation with an attorney
- Accident investigation and gathering evidence.
- Filing a claim against the at-fault driver’s insurer or the driver personally.
- Negotiating to reach a fair settlement.
- If a fair settlement can’t be negotiated, a formal lawsuit will be filed, and the case will go to trial.
The Role of Expert Testimony in Proving Brain Stem Injury
One of the biggest disputes is the extent of the injury, and with brain injuries, this could amount to six-figure sums won and lost. The evidence might prove negligence, but it might not prove injury severity, and this is why expert witnesses are critical for providing expert opinions.
Medical experts like neurologists and neuropsychologists are there to explain the injury and its impact on patients. Life care planners may also be brought in to outline an accident victim’s individual care needs in the years to come.
Dealing With Insurance Companies After a Brain Stem Injury
Auto insurance companies are there to minimize payouts, especially when severe injuries are in play. The last thing you want when dealing with such an injury is an auto insurance adjuster attempting to downplay your injury and shift the blame onto your shoulders.
Unfortunately, it’s a sad part of the insurance claims system, which is why an experienced personal injury lawyer is your shield against scrupulous insurers.
Understanding Your Rights: What Compensation May Cover
All accident victims have the right to pursue compensation if they were the victims of negligence. In states like Texas, with shared fault laws, they retain the right to seek compensation even if they were partially at fault.
Your settlement package aims to cover your losses, even if it’s impossible to turn back the clock. Examples include:
- Medical costs
- Lost wages
- Property damage
- Vehicle replacement
- Pain and suffering
- Loss of consortium
- Loss of companionship
- Wrongful death
Many people don’t understand what they’re entitled to, which results in them receiving a settlement that doesn’t actually cover their losses. And when you accept a settlement, you can’t make any further claims.
The Importance of Legal Representation in Securing Fair Compensation
Hiring a lawyer should be non-negotiable in high-value cases involving severe injuries to the brain stem. Your decision will define your long-term future and that of your family. Contrary to what many think, attorneys don’t just file paperwork.
They also:
- Explain your legal rights.
- Calculate the true value of your case.
- Investigate the incident.
- Collect evidence to build the strongest possible case.
- Negotiate with insurers.
- Negotiate with opposing counsel.
- Represent you in court.
Moreover, most lawyers work on a contingency fee basis, meaning you don’t pay anything unless you win your case. At DJC Law, we know how scary dealing with a severe injury and pending legal action can be. That’s why we provide the empathetic support families need to win their cases while giving themselves the breathing space needed to focus on healing.
If you’re ready to hold negligent parties to account, contact us for your free consultation now.
Frequently Asked Questions About Brain Stem Injuries
Can a patient fully recover from a brain stem injury?
Recovery prospects vary widely. It’s not unheard of for patients to fully recover, especially if the injury is mild. Still, many others will live with impairments for the rest of their lives, even if they make considerable progress.
What is the prognosis for brain stem injury patients?
The prognosis depends on a range of risk factors, including the location of the injury, its severity, and the patient’s overall health. A fit and healthy patient in their 20s will always have a better prognosis than a patient in their 80s with the same injury in a poor state of health.
Can I receive compensation for a brain stem injury if I was partially at fault?
You may still receive compensation for a brain stem injury if you were partially at fault, but it depends on the state. Texas uses a modified comparative negligence system with a 51% bar rule. If you were less than 51% responsible for your accident, you’re still entitled to receive financial compensation.
