stroke

Strokes: Effects, Limitations and Care

A stroke can happen at any time and to anyone. Known as a “brain attack,” strokes occur when blood flow is cut off to certain areas of the brain. When brain cells are deprived of vital oxygen, they die.

Nearly 800,000 people experience a new or recurrent stroke each year. It’s the fifth leading cause of death in the United States, and the leading cause of adult disability in the nation.

The effects and limitations of a stroke vary from person to person. Some make a full recovery, while others are left with permanent damage.

Types of Strokes

There are several different types of strokes, including:

Ischemic Stroke

An ischemic stroke occurs when a blood vessel in the brain becomes obstructed. This is the most common type of stroke, accounting for 87% of all cases.

The primary cause of an ischemic stroke is atherosclerosis, which occurs when fatty deposits build up in the lining of vessel walls. These deposits can cause blood clots that obstruct blood vessels and cut off oxygen to certain areas of the brain.

Hemorrhagic Stroke

A hemorrhagic stroke occurs when a weakened blood vessel in the brain ruptures. There are two main types of weakened blood vessels that can cause this type of stroke:

  • Arteriovenous malformations (AVMs)
  • Aneurysms

Uncontrolled high blood pressure is the leading cause of hemorrhagic strokes.

TIA (Transient Ischemic Attack)

A TIA is also known as a “mini stroke,” and it’s caused by a serious but temporary clot. These are considered warning strokes, and they should be taken very seriously.

Because a TIA doesn’t typically cause permanent damage, they’re usually ignored. But they should be viewed as a serious warning that a full-blown stroke may be in the near future.

Cryptogenic Stroke

A cryptogenic stroke is a stroke with no determinable cause. Extensive testing may be required to try and determine the cause of the stroke.

Brain Stem Stroke

Strokes that occur in the brain stem are called brain stem strokes. This type of stroke can affect both sides of the body, and cause the victim to remain in a “locked-in” state. When this happens, the patient is usually unable to speak or even move below the neck.

The Effects of a Stroke

The cell death brought on by a stroke affect the abilities linked to the area of the brain affected by the attack. For many people, this means losing memory function or muscle control.

The brain is a complex organ, and it’s difficult to know for sure how a stroke will affect a person until after the attack. It will primarily depend on the area of the brain and how much of the tissue has been impacted by the stroke.

It’s important to remember that the left side of the brain affects the right side of the body and vice versa.

Here’s what can happen when a stroke impacts each side of the brain:

Right Brain

  • Paralysis on the left side of the body
  • Vision problems
  • Memory loss

Left Brain

  • Paralysis on the right side of the body
  • Speech or language problems
  • Memory loss

If the stroke occurs in the brain stem, both sides of the body can be affected, depending on the severity of the injury.

Limitations

Depending on the location and severity of the stroke, victims may have to face several challenges and limitations moving forward.

Physical limitations are the most obvious effect. Paralysis may occur, which can make it difficult or impossible to walk without a mobility device. Stroke victims may also experience:

  • Difficulty with fine motor skills
  • Spasticity
  • Visual disturbances
  • Shoulder weakness
  • Hand and wrist weakness
  • Decreased sensation
  • Difficulty determining where their body is in space

These physical limitations will undoubtedly impact the person’s daily life and activities. Rehabilitation may be able to restore some or all function, depending on the severity of the injury.

Stroke victims may also experience communication challenges or cognitive deficits, such as difficulty solving problems. Depending on the location of the stroke, the victim may suffer from aphasia, a condition that affects the person’s ability to understand or process language. Speech and attention issues may also occur. Right-brain strokes can impact a person’s problem-solving skills.

Other limitations aren’t clearly visible or audible. Many stroke victims suffer emotional and behavioral changes following the attack. Depression is common among stroke victims, and many lose their self-confidence following the attack.

Care

Stroke care and treatment will depend on the type of stroke.

Ischemic Stroke

The primary goal when treating this type of stroke is clot removal. Clots can be removed either with medication or through mechanical treatments.

Alteplase IV r-tPA is a medication treatment that is considered the “gold standard,” according to the American Stroke Association. Also known as alteplase, this drug has been approved by the Food and Drug Administration (FDA) to treat ischemic strokes. It is administered via an IV in the arm, and it works to dissolve the clot and restore blood flow to the affected area of the brain.

Unfortunately, most people don’t arrive at the hospital quickly enough for this medication to be as effective as it could be. Early detection of the stroke can help maximize the benefits of the drug.

Doctors can also attempt to remove the clot manually through either a mechanical thrombectomy or an endovascular procedure. This procedure requires doctors to use a stent retriever (a wire-cage device). A catheter is sent up through an artery in the groin to the blocked artery in the brain. The stent then opens and grabs the clot.

In some cases, doctors may use special tubes to remove the clot.

The procedure must be performed within six hours of the stroke symptoms, but some benefits may still be experienced if performed within 24 hours of onset.

Hemorrhagic Stroke

With a hemorrhagic stroke, the goal is to stop the bleeding. It’s also important for doctors to understand the cause of the stroke.

In most cases, hemorrhagic strokes are caused by uncontrolled high blood pressure.

Mechanical treatments may be used to stop the bleeding. A small catheter may be sent up through a major artery in the leg or arm to the brain tissue. This allows the surgeon to see the problem. Once the source of the bleeding is identified, a mechanical agent can be deposited to prevent further rupture.