Brainstem and Thalamus
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The brainstem is like a tube that begins underneath the brain and extends down until it becomes part
of the spinal cord. It is has three areas: the midbrain, pons and medulla. The brainstem is very
important because it handles automatic functions like breathing and heart rate.
The thalamus is a small structure located slightly above the brainstem. It is the gateway for most of
the sensory pathways. The thalamus plays a role in regulating awareness and emotional aspects of
sensory experiences (reaction to fear or hunger, for example).
Symptoms of brainstem and/or thalamus injury depend on the extent and specific location of the
injury.
The following symptoms may occur:
problems controlling blood pressure
problems with sight and eye movement
problems with breathing
problems closing eyes and moving face
decreased wakefulness/arousal
problems with hearing and balance
problems swallowing or coughing
Another condition that may occur when there are injuries near the brainstem and thalamus is
“storming.” Storming is also called hypothalamic instability or paroxysmal sympathetic storms. A
storming episode may happen as a result of a stimulus or when the person is resting quietly. It may
last several minutes and can happen at various times throughout the day.
Signs of storming include an increase in heart rate, temperature and sweating. There also may be a
rise in the blood pressure and muscle stiffness or rigidity during the episode. Storming happens
