What is a Stroke?

The information was created by our in-house Occupational Therapist to help guide you through the process of what happens following a stroke. We understand it can be a minefield trying to not only contend with a life-changing event but also figure out what is happening and what may happen in the future. We hope this will help you on your journey.

What's happened?

Many people will have seen adverts or heard of the test for Stroke and the need to Act FAST which means: Face - has the person had face droop on one side? Arms- can the person raise both their arms and keep both arms raised? Speech - does the person appear able to understand and to make sense when speaking? Time - if these signs are present you must get an ambulance or drive the person to hospital urgently. A Stroke is an injury to the brain due to either a clot in, or a clot travelling to the brain, or a haemorrhage (bleeding) in the brain.

What does it mean?

The clot or bleed on the brain injures brain cells which causes a malfunction in the brain controlling our abilities such as walking, talking and understanding. Because of the way the brain is wired, a stroke on one side affects the abilities of the other side - in the case of muscle weakness, a stroke on the left side of the brain will affect the arm and leg on the right side of the body. Smaller strokes are called TIAs (transient ischemic attacks). These can be recurrent and usually leave no permanent injury. However, these can be a sign that a larger stroke is on the way and therefore the person needs to be monitored and perhaps given preventative medication, depending on the cause of the TIA.

What happens next? 

At the hospital they will want to establish what has caused the stroke (via scans) and therefore what treatment is needed - clots and bleeds need different treatment which may include clot busting drugs or an operation. Within the hospital they may refer to the stroke as a CVA (cerebrovascular accident) - The aim of the treatment will be to stabilise the person who has had a stroke to try to prevent further strokes. - There will be many individuals involved with the person's rehabilitation at the hospital including the physiotherapists, speech and language and occupational therapists. (article for further info) - Over the next few days there can be a huge improvement in the person and then the improvement slows down. Or if the stroke affected a larger part of the brain, improvement may be very slow. It is a huge shock to the patient and family/friends - the emotional effects of stroke can be ongoing for some time or a person may bounce back quite well but still with an insecurity that it may happen again. A stroke rarely leaves the person without some kind of deficit.

What's the medium to long term prognosis?

How much improvement is made depends on the 'density' of the stroke and what areas of the brain have been affected.  The brain scans will show any areas of the brain where cells have been killed off (infarcts) and doctors can then tell what areas are affected and what problems the person will have to overcome. (further article regarding common impairments) Fortunately, the brain does have a system in place to try and overcome or compensate for the injuries. This is called neural plasticity. It means that the brain tries to find new routes for information to travel around in the brain or new areas of the brain to take on more jobs. How well and how quickly this happens is down to, as we have already said, where the brain is injured but also how motivated the person is to engage in rehabilitation, how regularly they undertake rehab and how well they are able to manage the emotional side of rehab. There may also be unknown factors which make one brain injury more responsive to treatment than another. Research has shown that improvement can still be made for around 2 years post-stroke but it can be very slow.

Useful References https://www.nhs.uk/actfast/Pages/stroke.aspx For more information and support please visit https://www.stroke.org.uk/ or call them on 03033 033100

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