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Stroke Recovery

A stroke can be frightening, but recovery does take place. After rehabilitation, most people regain lost skills and maintain a high quality of life.

IF BRAIN DAMAGE TAKES PLACE, HOW CAN A PERSON RECOVER?

That's a good question! The brain is a remarkable organ. When the blood flow is cut off, new pathways can take over and supply the blood to that damaged area. Also, the brain can make compensations. One area will take over the functions that were previously handled by a different area. Remember, people can and do recover from a stroke!

WHAT ARE THE STEPS OF RECOVERY FROM A STROKE?

Usually, recovery happens in phases. It takes place over a period of time that can vary from a few weeks to a few years. Every stroke is different and the extent of damage varies. Below are the general phases that a stroke survivor can expect to go through.

� TREATMENT FOR THE ACTUAL STROKE- This begins when a person first enters the hospital. Doctors will determine the type of stroke and will provide the appropriate treatment. This may consist of drugs to break up clots and thin the blood or surgery to repair a broken blood vessel. Treatment is aimed at preventing another stroke from taking place and limiting the amount of brain damage that occurs.

� RECOVERY- After a stroke, some spontaneous recovery takes place for most people. Abilities that may have been lost will begin to return. This process can take place very quickly over the first few weeks, and then, it may begin to taper off.

� REHABILITATION- This phase usually takes place while the patient is still in the hospital. Various therapists and specialists will work with the stroke victim to bring back lost skills. This can be a very frustrating time for the patient as they become aware of their limitations from the stroke. Often, this is the period where anger or depression can set in. It's good to remember that with proper therapy, many or most skills can be relearned.

� RETURNING TO THE HOME ENVIRONMENT-This can be a very exciting time, but adjustments may have to be made. Some of the adjustments might be temporary or some may last for a lifetime.

For the stroke victim, simple tasks such as tying shoes or fastening pants can be difficult. These are easy to remedy. Velcro shoes and drawstring pants can be worn. Other issues may not be as easy. But take courage. There will be many experts to ease this transition.

A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. The paralysis or weakness may affect only the face, an arm, or a leg or may affect one entire side of the body and face. A person who suffers a stroke in the left hemisphere of the brain will show right-sided paralysis or paresis. Conversely, a person with a stroke in the right hemisphere of the brain will show deficits on the left side of the body. A stroke patient may have problems with the simplest of daily activities, such as walking, dressing, eating, and using the bathroom. Motor deficits can result from damage to the motor cortex in the frontal lobes of the brain or from damage to the lower parts of the brain, such as the cerebellum, which controls balance and coordination. Some stroke patients also have trouble swallowing, called dysphagia.

Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. In some cases of stroke, the patient suffers a "neglect" syndrome. The neglect means that a stroke patient has no knowledge of one side of his or her body, or one side of the visual field, or is unaware of the deficit. A stroke patient may be unaware of his or her surroundings, or may be unaware of the mental deficits that resulted from the stroke.

Stroke victims often have problems understanding or forming speech. A deficit in understanding or forming speech is called aphasia. Aphasia usually occurs along with similar problems in reading or writing. In most people, language problems result from damage to the left hemisphere of the brain. Slurred speech due to weakness or lack of coordination of the muscles involved in speaking is called dysarthria, and is not a problem with language. It can result from any weakness of the speech muscles, dysarthria can arise from damage to either side of the brain.

A stroke can lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions in certain situations. One common disability that occurs with many stroke patients is depression. Post-stroke depression may be more than a general sadness resulting from the stroke incident. It is a clinical behavioral problem that can hamper recovery and rehabilitation and may even lead to suicide. Post-stroke depression is treated as any depression is treated, with antidepressant medications and therapy.

Stroke patients may experience pain, uncomfortable numbness, or strange sensations after a stroke. These sensations may be due to many factors including damage to the sensory regions of the brain, stiff joints, or a disabled limb. An uncommon type of pain resulting from stroke is called central stroke pain or central pain syndrome (CPS). CPS results from damage to an area in the mid-brain called the thalamus. The pain is a mixture of sensations, including heat and cold, burning, tingling, numbness, and sharp stabbing and underlying aching pain. The pain is often worse in the extremities - the hands and feet - and is made worse by movement and temperature changes, especially cold temperatures. Unfortunately, since most pain medications provide little relief from these sensations, very few treatments or therapies exist to combat CPS.