Stroke of the Medulla Oblongata: What Happens, Survival Rate, and More
Medically reviewed by Kimberly Brown, MD
A stroke in the medulla oblongata, also known as a medullary stroke, is a rare type of stroke that affects the medulla oblongata, a structure in the brain that transfers nerve messages to the spinal 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 with arterial 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 experiencing stroke 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.
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What Is the Medulla Oblongata?
The brainstem is the stalk-like feature located at the base of the brain. It is comprised of three sections: the midbrain, 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 and autonomic functions that are essential for life.
Function of the Medulla Oblongata
Autonomic functions are those your body does automatically. Autonomic functions controlled by the medulla oblongata include:
Blood pressure regulation
Breathing rate and depth
Digestion
Perspiration (sweating)
The medulla oblongata is also your brain's reflex control center. It is responsible for activating such reflexes as:
Vomiting
Coughing
Sneezing
Gagging
Pupil dilation
Defensive reflexes, such as withdrawing your hand when something is hot
Escape reflexes, such as jumping or flinching when startled
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:
Paralysis on one or both sides of the body
Double vision
Coordination problems
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:
Severe headaches that start suddenly and get worse when you change positions, bend, strain, or cough
Double vision
Numbness in the arm, face or leg on one side
Weakness of the face, arm or leg on one side
Dizziness
Difficulty walking
Loss of balance or coordination
Persistent hiccups
Loss of consciousness
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.
Risk Factors
Risk factors for a medullary stroke are the same as the risk factors for strokes in other areas of the brain. They include:
High blood pressure
A family history of stroke
Elevated cholesterol and triglycerides
Age
Ethnicity
Smoking
Physical inactivity
It is also possible for a medullary stroke to happen after a sudden head or neck movement injures an artery. This is rare, however.
Diagnosis
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, a neurologist can 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 brain CT scan or a brain MRI can 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 or angiogram may 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.
Related: 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 healing also 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 your rehabilitation.
Related: 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.
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