When people refer to a stroke, they are typically talking about what is known in medical circles as a cerebrovascular accident (CVA). A CVA may be either an ischaemic stroke or an hemorrhagic stroke.
In an ischaemic stroke, a blood clot or other blockage cuts off blood flow to the brain. These blockages do not resolve without medical intervention and delays in treatment can result in the death of large portions of brain tissue, causing permanent disability or death. In hemorrhagic strokes, a blood vessel in the brain breaks and causes bleeding inside the brain, also leading to catastrophic loss of brain tissue.
Risk Factors
Risk factors for stroke include obesity, smoking, high blood pressure and the use of certain oral contraceptives. Diabetes and high cholesterol can also be contributing factors.
Another risk factor is a history of TIAs - transient ischaemic attacks. These “mini-strokes” are caused by a temporary blood flow restriction in the brain. People who experience TIAs are especially at risk of experiencing a CVA in the following 48 hours.
Symptoms
Image credit: Mercy Health
It’s important to recognize the signs of a stroke so that you can get help for yourself or others as quickly as possible. Symptoms of a CVA or TIA are similar and include:
Facial weakness - the stroke victim may be unable to smile, and their mouth and eye on one side of the face may droop visibly.
Weakness on one side of the body – when a person has a stroke they will experience weakness on the side of the body opposite the side of the brain experiencing the stroke. If the person is unable to lift both arms, this may be a sign of a stroke
Aphasia – the stroke victim may lose their ability to speak, slurring their words or speaking unclearly. They may also have trouble understanding others or repeating what they’ve been told. This is most common in strokes affecting the left side of the brain where speech centers are located.
Acting fast in the face of any of these symptoms is key to helping a stroke victim survive with as little long term effect as possible. When someone experiences a TIA, the symptoms may only last for a few minutes, or up to 24 hours, but it’s important not to ignore the signs and to seek medical attention immediately because of the heightened risk of a CVA.
Treatment
You’ll undergo testing such as MRIs and CT scans in order to determine the course of preventative action necessary. You may be prescribed blood-thinners to help increase blood flow to your brain, or need to undergo a procedure to remove plaque (fatty deposits) from inside the blood vessels leading to your brain. If a blood clot is the cause of your TIA/CVA, a procedure to trap and remove the clot called a thrombectomy may be performed.
Long Term Recovery
Outcomes for stroke victims vary widely from individual to individual, and is especially dependent on how quickly treatment is received. A major goal for many stroke victims will be to regain strength and mobility in the side of their body that experienced the effects of their stroke. Some therapies for recovery you may work on with a physical therapist include:
Constraint-induced movement therapy (CIMT) which involves restricting movement of the unaffected side while forcing use of the affected side
Mirror Therapy involves the use of a mirror on a tabletop and looking at a reflection of the unaffected arm/hand moving. In this way you can “trick” the brain into sending signals to the affected limb, helping to activate neuroplasticity and restore movement.
Balance and gait training which will help people get out in their community with a lesser chance of falls
In addition, your recovery team will work with you to make safety enhancements to your home, like rearranging things temporarily to avoid using stairs when possible, and eliminating fall hazards to prevent the chance for new injuries while you’re in a vulnerable state.
Even for victims of severe strokes, strong recovery is possible and many people are able to return to an active lifestyle.