From the Guidelines

Yes, a brainstem stroke can cause tachypnea, which is characterized by an abnormally high respiratory rate.

Abnormal respiratory patterns, including central neurogenic hyperventilation, can occur due to lower brainstem dysfunction in the late stages of a stroke 1.
These patterns may include ataxic respiratory patterns and periodic breathing, which can be indicative of brainstem involvement.
Brainstem compression and dysfunction can lead to a range of respiratory abnormalities, including changes in breathing rate and depth.
The development of abnormal respiratory patterns, such as tachypnea, can be a sign of worsening brainstem function and may require prompt medical attention.
It is essential to monitor patients with brainstem strokes closely for signs of respiratory dysfunction, including tachypnea, and to provide supportive care as needed to manage these symptoms 1.

From the Research

A brainstem stroke can cause tachypnea (high respiratory rate) as evidenced by a study published in 1976 2, which found that sustained tachypnea developed in five patients with acute brain stem infarction, four of whom died.
The study also found that abnormalities of respiratory rate and pattern, including tachypnea, were observed in all patients with acute brain stem infarction, and were related to the size and bilaterality of the lesions rather than the level of the lesions.
Another study published in 2008 3 found that neurologic disorders affecting the brainstem, including brainstem stroke, can lead to abnormal breathing patterns, including tachypnea.
A study published in 2022 4 also found that brainstem stroke can cause specific patterns of respiratory dysfunction, including abnormalities in respiratory pattern and loss of airway protection, which can lead to respiratory failure.
Additionally, a study published in 1994 5 found that the automatic pathway of respiration, which is controlled by the brainstem, can be damaged in lateral medullary strokes, leading to respiratory dysfunction.

The mechanism of tachypnea in brainstem stroke is not fully understood, but it is thought to be related to the disruption of the normal functioning of the brainstem respiratory centers 2, 3.
The brainstem respiratory centers, including the pontine respiratory group and the dorsal and ventral respiratory groups in the medulla, play a critical role in controlling respiration 3.
Damage to these centers, such as in a brainstem stroke, can lead to abnormal breathing patterns, including tachypnea 2, 3, 4.

Patients with brainstem strokes often experience a range of clinical characteristics, including hemiparesis, ataxia, diplopia, dysarthria, and dysphagia 6.
Pneumonia is a common complication in patients with brainstem stroke, occurring in 11% of patients in one study 6.
The risk factors for brainstem stroke include diabetes, hypertension, and previous stroke 6.