OUR SERVICESStroke, the third leading cause of death in the U.S. – after heart disease and cancer – is the leading cause of serious disability among Americans. According to a major study, more than half a million people each year have a stroke.
However, there is encouraging news. Improvements in medical care of stroke patients and awareness and control of high blood pressure have led to a decline in stroke deaths. Doctors and scientists are intensively investigating the causes and treatment of stroke.
Understanding Stroke
A stroke occurs when there is a blockage or rupture in a vessel that carries blood to the brain, causing the blood supply to be cut off and brain tissue to die. When this happens, the specific part of the brain affected can no longer function, nor can the part of the body it controls.
Stroke, therefore, can lead to difficulty in walking or speaking, memory loss or other symptoms. Depending upon the severity of the stroke, the damage can range from slight to life-threatening.
There are several different causes of stroke. The most common is when a blood clot, or thrombus, forms in an artery in the neck or brain and blocks the flow of blood. Clots are often seen in people with atherosclerosis, or “hardening of the arteries,” the slow, silent process in which blood vessels narrow because of thick, fatty deposits linked to high blood cholesterol.
Other causes of stroke include a clot that is carried through the bloodstream, known as an embolus, which lodges in the brain or an artery leading to the brain. These clots often occur in people with heart disease.
A stroke can also be caused when an artery in the brain bursts or leaks, causing bleeding into surrounding brain tissue. This is called an intracerebral hemorrhage and is often associated with high blood pressure. A subarachnoid hemorrhage occurs when a blood vessel on the brain ruptures and bleeds between the brain and skull. Less common causes of stroke include arterial compression due to injury or tumors.
Risk Factors and Prevention
A stroke can be fatal or cause a loss in a person’s ability to function physically and mentally. No one is completely immune to the possibility of stroke. But there are significant risk factors of which you should become aware.
Some risk factors cannot be controlled, such as age. The older a person becomes, the greater the risk of stroke. In addition, men are more likely to have stroke than women, and blacks more likely than whites; people with diabetes and those who have had a previous stroke are also at higher risk.
Some risk factors can be controlled. The most important controllable risk factor for stroke is high blood pressure, or hypertension. People taking medication for hypertension must be certain to take their prescription as directed and should have their blood pressure checked regularly.
Another major risk factor in stroke is heart disease. Some secondary risk factors, which heighten the risk of stroke by increasing the risk of heart disease, can be controlled. They include:
- High blood cholesterol levels
- Smoking
- Excessive use of alcohol
- Obesity
Warning Signs
It is wise to become familiar with the warning signs of stroke. They are usually temporary and appear suddenly:
- Weakness or numbness of the face, arm or leg
- Vision loss, often in only one eye
- Double vision
- Difficulty speaking
- Dizziness or unsteadiness
- Change in personality or mental ability
According to the American Heart Association, one in ten stroke patients may suffer a warning episode known as a transient ischemic attack, or TIA. This stroke-like episode occurs when a blood clot temporarily blocks an artery in the brain. The signs of a TIA are the same as in a stroke, but almost always last no more than 10 to 15 minutes and disappear within 24 hours.
The most important thing to know about a TIA is that it can be a serious warning that a major stroke will occur.
Recovering from a Stroke
For several days after suffering a stroke, a patient may be in critical condition as the brain recovers from its injury. During this time, the medical team closely monitors swelling in the brain and how quickly it decreases. In about a week, most patients stabilize and the medical team has a clear picture of the extent of the stroke.
The American Heart Association reports statistics that show that the rate of recovery from stroke is greatest in the first three to six months, when most people regain 75 percent of their abilities. Patients tend to achieve their fullest potential within a year.
Rehabilitation
The process of returning to good health after a stroke can be long and trying. However, a well-designed rehabilitative program can help a patient make great strides toward full recovery.
The physical effects of a stroke, which depend on its type and location, can include problems with the senses, speech, behavior, comprehension, thoughts patterns and memory, as well as gait disorders and difficulty swallowing. Paralysis can occur on one side of the body, causing pain and trouble moving.
Many factors determine how a patient will fare after a stroke, and recuperative abilities vary from person to person.
Because of the body’s capacity to compensate for partial blood loss in the brain, it is possible for a patient to improve the level of functioning, or return to normal after a stroke.
The earlier a patient begins therapy the better. Sometimes, exercises can begin the same day a stroke occurs. In addition to regaining lost functioning, rehabilitative exercise can help prevent secondary complications, such as pneumonia or bed sores. Any therapeutic regimens or medications prescribed for a patient should be followed fully.
Physical, occupation and speech therapy regimens can help a patient with paralysis and problems with coordination or speech. Physical therapists help a patient regain balance and muscle strength and control, as well as help lessen pain. The aim of occupational therapy is to help the patient remain independent by working on dressing, grooming, cooking and other activities of daily living. Speech therapists help patients regain communicative powers that may have been lost after a stroke.
In addition to these therapeutic efforts, family members, social workers and other professionals can help a person who has had a stroke cope with the emotional and physical challenges during rehabilitation. Significant feelings of anxiety and loss of self-esteem that can be common after a stroke, as well as mental changes that can frustrate and confuse both patient and family, need to be addressed to speed the entire recovery process.