Brain Stem Damage: 8 Warning Signs and Next Steps

Last Updated: November 6, 2026

The hindbrain includes the brain stem and controls vital functions such as respiration and heart rate. A traumatic brain injury can affect consciousness. More serious traumatic brain injury can lead to severe and permanent disability, and it can cause death. Brain stem injuries can be life-threatening and need timely emergency medical attention. If a legal claim is later pursued, outcomes depend on the facts and proof; cases often turn on medical records and, when liability or damages are disputed, qualified medical expert review. These situations frequently overlap with spinal cord and brain injury representation.

What Occurs if the Brain Stem Becomes Damaged?

The brain stem is part of the hindbrain. The National Institute of Neurological Disorders and Stroke says the hindbrain controls vital functions such as respiration and heart rate. MedlinePlus says the brain stem controls breathing. The National Institute of Neurological Disorders and Stroke says the brain stem, made up of the pons, the medulla, and the midbrain, controls the transitions between wake and sleep. The hypothalamus also contains groups of nerve cells that affect sleep and wakefulness. When the brain stem is injured or affected, changes can happen fast and can be serious.

If you are in Peoria or Central Illinois and someone has had a head or neck injury, medical care comes first. This article is general information, not medical advice. If you are worried about a life-threatening problem, call 911.

If the injury happened in a crash, fall, or other preventable event, you can also learn more about our Peoria brain and spinal cord injury work and what the insurance process often looks like in Illinois.

First: Treat Possible Brain Stem Damage as an Emergency

Some head injuries show up slowly. But symptoms tied to the brain stem can involve breathing, consciousness, and swallowing, things that are unsafe to “wait and see” about.

Get emergency help right away if the person is hard to wake, has trouble breathing, suddenly can’t swallow, is repeatedly vomiting, has a seizure, has new weakness, or seems confused in a way that is not normal for them. If you can, note the time symptoms started and whether they are getting worse.

What the Brain Stem Does (in Plain Language)

The hindbrain includes the upper part of the spinal cord, the brain stem, and the cerebellum. The brain stem includes three main parts: the midbrain, the pons, and the medulla oblongata. MedlinePlus describes the brain stem as those three parts and describes the cerebellum as a separate structure. The cranial nerves other than the olfactory and optic nerves come from the brain stem.

The uppermost part of the brain stem, the midbrain, controls some reflex actions and is part of the circuit involved in the control of eye movements and other voluntary movements. The cerebellum coordinates movement.

How Brain Stem Damage Can Happen

Sometimes brain stem damage is related to trauma, like a car crash, motorcycle collision, fall, or assault. The National Institute of Neurological Disorders and Stroke describes traumatic brain injury as injury from an outside force, including a forceful bump, blow, or jolt to the head or body, or an object entering the brain. A rapid movement of the brain within the skull, which can happen when a person is violently shaken, can cause a concussion. MedlinePlus describes that movement as the brain bouncing or twisting and damaging brain cells.

Bleeding in or around the brain, and swelling, can follow trauma. Stroke warning signs appear suddenly, when the brain is not receiving enough oxygen. A brain tumor can lie near the brain stem, and some gliomas spread through the brain stem. Brain infection, stroke, and a cervical spine condition can affect the brain stem. Loss of oxygen can affect any part of the brain, and cerebral hypoxia is a medical emergency when someone is losing consciousness. The right diagnosis depends on the person’s history, exam, and testing.

Brain Stem Injury Symptoms and Warning Signs

After a head injury, get immediate medical attention for a new or worsening problem, especially in the first 24 hours. The National Institute of Neurological Disorders and Stroke lists headache, seizure, blurred or double vision, unequal pupils, clear fluid from the nose or ears, nausea or vomiting, slurred speech, weakness of an arm, a leg, or the face, loss of balance, loss of consciousness, trouble waking, and confusion as reasons for that immediate attention. A brain stem injury is one possible cause. Another serious brain injury can cause the same signs. MedlinePlus lists unusual eye movements and symptoms in one eye as emergency symptoms of a more severe traumatic brain injury. It lists double vision or blurred vision as a reason to contact a provider right away. MedlinePlus also describes trouble swallowing food, liquid, or saliva, including after a stroke or a head or spinal cord injury. Its stroke warning signs include sudden trouble walking, dizziness, and loss of balance, plus face drooping and slurred speech. The list below has eight warning signs.

New trouble breathing
Being unusually sleepy, difficult to wake, or losing consciousness
New trouble swallowing food, liquid, or saliva
Sudden dizziness, severe balance problems, or trouble walking
Slurred speech, new confusion, or acting “not like themselves”
Double vision, blurred vision, symptoms in one eye, or unusual eye movements
Unequal pupils or a new drooping face
A severe headache, especially with repeated vomiting

If your concern is a possible internal bleed after a head injury, this related guide may help you understand what doctors usually consider urgent: How do I know if I am having a brain bleed after a head injury?

Some traumatic brain injury is immediate. Secondary damage can develop over hours, days, or weeks. MedlinePlus says some symptoms may not occur right away and can show up days or weeks later. If symptoms are getting worse instead of better, that is a reason to be evaluated.

What Doctors Usually Do to Check for Serious Problems

In an emergency setting, the medical team starts with safety: breathing, oxygen levels, and circulation. They will ask what happened and what symptoms started first, then do a neurological exam that checks alertness, speech, strength, sensation, reflexes, balance, and eye movements.

A physical examination and the person’s symptoms help determine whether imaging is needed. CT imaging can show a skull fracture and brain bruising, bleeding, or swelling. MRI is more sensitive and can pick up brain changes that a CT scan may miss. Imaging and other current tests cannot always detect damage from a mild, concussive injury. MedlinePlus lists a head CT, an MRI of the brain, and x-rays among tests that may be done. It says head injuries that cause a traumatic brain injury often occur with an injury to the neck and spine, and that people who have had a head injury should be moved with special care. For a severe injury, emergency care includes oxygen delivery and breathing support, control of blood pressure, and monitoring of pressure inside the skull.

What Recovery and Daily Life Can Look Like

Brain damage from a traumatic brain injury may be temporary or permanent, and recovery can take a long time. More serious injury can lead to severe and permanent disability, and it can cause death. After a severe injury is treated and stabilized, people are often transferred to a rehabilitation center. The team may include physical, occupational, speech, and respiratory therapists. Treatment may be needed for a short time or for a long time.

Severe traumatic brain injury care includes oxygen delivery and breathing support. Some people need careful monitoring for breathing or swallowing. Dizziness, confusion, and fatigue can start immediately and may resolve over time. Nausea, vomiting, and loss of balance are reasons for immediate medical attention. Those problems can make driving, working, or walking on uneven ground harder. More on brain and spinal cord injury attorneys in Peoria is available on our practice page.

Follow-up matters. MedlinePlus says healing from a traumatic brain injury can take days, weeks, or months. During that time a person may have a hard time with tasks that require memory or concentration, and may be very tired, dizzy, or have blurry vision at times. Those problems will probably recover slowly. In a small number of people, the symptoms do not go away. Therapy notes (physical therapy, occupational therapy, speech therapy) often become important records of what changed and how the person is improving.

What to Save and Write Down After a Crash, Fall, or Other Incident

If the injury may involve insurance (auto, premises, or another claim), good documentation protects you. It can also help the doctors by giving them a clear timeline.

The date, time, and general location of the incident, plus photos of the scene and any visible injuries
Emergency room paperwork, discharge instructions, and any return-precautions you were given
A simple symptom timeline (what you noticed right away, what showed up later, what got worse)
Follow-up visit notes, therapy notes, and imaging reports if you receive them
Work or school notes, restrictions, and time missed
A short daily log of activities that became harder (sleep, driving, reading, walking, chores)

In serious injury cases, the most helpful records are usually the ones created close in time to the symptoms and updated consistently.

Common Mistakes That Can Hurt Health and the Claim

People often minimize symptoms right after an accident because adrenaline is high or they want to get home. Then symptoms show up later, and the first record makes it sound like nothing was wrong. If symptoms change, tell your provider so the record stays accurate.

Gaps in care can also create problems. Insurance companies frequently argue that a long gap means the person must have been better, or that something else caused the problem. If you cannot afford care or cannot get an appointment, document that too.

What Insurance Companies Often Look For in a Serious Brain Injury Case

Insurance companies tend to evaluate brain and nerve injuries by looking for consistency and “objective” support. That can include imaging, neurological exam findings, therapy testing, and repeated documentation of the same complaints over time.

They also compare the mechanics of the event to the claimed injury. In Central Illinois, that can come up in highway crashes, winter-weather collisions, and construction-zone wrecks where sudden stops and violent rotations happen quickly.

In the most severe cases, families may be dealing with permanent disability or even loss of life. If your loved one passed away after complications from a brain stem injury, our Illinois wrongful death page explains the respectful, evidence-focused steps that usually matter early on.

No two cases are the same. A steady approach helps: get the right medical care, follow the treatment plan, and keep the timeline and paperwork accurate.

Frequently Asked Questions

Is brain stem damage always life-threatening?

It can be, because the brain stem helps control breathing and heart rhythm, and it controls the transitions between wake and sleep. The hypothalamus also affects sleep and wakefulness. Outcomes vary widely based on the cause, the severity, and how quickly the person gets appropriate medical care. The safest step is prompt evaluation when serious symptoms are possible.

Can brain stem symptoms show up later after a crash?

Some head and neck symptoms can be delayed after a collision. If new symptoms appear, or if symptoms are getting worse instead of better, it is a sign to get checked. For emergency signs like trouble breathing, repeated vomiting, confusion, or being hard to wake, get urgent care right away.

What tests might be used to check for a serious problem?

A physical examination and the person’s symptoms help determine whether imaging is needed. CT imaging can show a skull fracture and brain bruising, bleeding, or swelling. MRI is more sensitive and can pick up brain changes that a CT scan may miss. Severe injury care includes oxygen delivery and breathing support. If speech, swallowing, or balance are affected, therapy evaluations may be part of the record as well.

What records matter most if insurance is involved?

Early medical records usually matter most: emergency room notes, imaging reports, discharge instructions, follow-up notes, and therapy testing. A simple symptom timeline can also help connect the dots across providers without guessing.

Need a lawyer? This article is part of our Peoria Brain & Spinal Cord Injury Lawyer practice area. Call Parker & Parker at 309-673-0069 for a free consultation.

Brain Stem Damage: Warning Signs & Next Steps | Peoria