What is a stroke?
A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications.
The two main types of stroke are:
- Ischemic stroke. This is the most common type of stroke, accounting for 87 percent of strokes. It happens when a blood clot blocks blood flow to part of your brain.
- Hemorrhagic stroke. This happens when a blood vessel in the brain breaks and bleeds into the brain. Brain cells die because of the sudden bleeding and pressure and/or lack of blood flow. It accounts for 13 percent of strokes.
The effects of a stroke depend on the location of the obstruction and the extent of brain tissue affected. However, strokes can cause paralysis, speech problems, loss of memory and reasoning ability, coma, or death. A stroke can happen to anyone at any time. It strikes suddenly, and often there are no warning signs. But getting fast treatment can help reduce damage to the brain.
Can you survive a stroke?
Yes, it is possible to survive a stroke. With prompt treatment and rehabilitation, many people are able to recover from strokes.
According to the American Stroke Association, over 795,000 people in the United States have a stroke every year. Of these:
- 610,000 are first or new strokes
- 185,000 are recurrent strokes
On average, every 40 seconds someone in the United States has a stroke, and someone dies of one approximately every 3.5 minutes.
However, improvements in emergency care and treatment have vastly improved survival rates and recovery:
- About 87% of strokes are ischemic strokes, in which a clot blocks a blood vessel supplying the brain. A key treatment is tissue plasminogen activator (tPA), a medication that dissolves clots and improves blood flow. If given within 3 hours of symptoms, tPA can greatly reduce damage.
- Strokes cause nearly 133,000 deaths per year. Still, the death rate for strokes dropped by 35.1% between 2000 and 2015.
- About 80% of people survive their first stroke. After their first stroke:
- 21% recover with little to no disability
- 25% recover but have some lasting impairment or disability
- 40% have moderate to severe disabilities
So while strokes can be catastrophic, the majority of people survive them, especially with prompt treatment. Recovery is possible depending on the severity and proper rehabilitation.
What first aid should be given to someone having a stroke?
If you suspect someone is having a stroke, act F.A.S.T:
F – Face: Ask the person to smile. Does one side droop?
A – Arms: Ask the person to raise both arms. Does one arm drift downward?
S – Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?
T – Time: If you see any of these signs, call 9-1-1 immediately. Note the time the symptoms started.
Other steps you can take:
- Position the person so any fluids drain from their mouth.
- Keep them comfortable, stable, and supported.
- Do not give them anything to eat or drink.
- If a stroke is suspected, notify emergency services immediately. The sooner treatment starts, the better the chances of recovery.
Calling 9-1-1 rapidly is vital for the best outcome. Also take note of when the symptoms started or when the person was last seen normal. This information will help medical providers in starting treatment as fast as possible once the individual arrives at the hospital.
What are the treatments for stroke?
Treatment depends on the type of stroke and when the person reaches medical care. The goals are to:
- Restore blood flow to the brain (reperfusion)
- Stop any bleeding or pressure in the brain
- Prevent complications and further brain damage
Ischemic stroke treatments may include:
- Tissue plasminogen activator (tPA) – This “clot buster” medication must be given within 3 hours of symptoms. It dissolves the clot obstructing blood flow and improves recovery after a stroke. The sooner it’s given the better.
- Thrombectomy – This surgery removes large clots from blood vessels in the brain. It’s used if tPA does not dissolve the clot. This must be done within 6-24 hours of symptoms.
- Anticoagulants (blood thinners) – These medications help prevent new clots from forming and existing clots from getting larger.
- Antiplatelet agents – These reduce the risk of blood clot formation. Aspirin is a common one.
Treatments for hemorrhagic stroke aim to stop bleeding and reduce pressure in the brain. They may include:
- Medications to lower blood pressure, prevent vasospasm (blood vessel narrowing), and reduce brain swelling.
- Surgery to repair damaged blood vessels or malformations that caused the bleeding.
- Ventriculostomy – A drain is placed in the brain to drain excess fluid and relieve pressure.
After initial treatment, most stroke patients are admitted to the hospital stroke unit for close monitoring and to start rehabilitation.
What disabilities can result from a stroke?
The brain controls everything we do, from walking and talking to breathing and seeing. So a stroke can impact any of your abilities, depending on where it occurs and how much damage it causes in the brain. Common disabilities from stroke include:
- Paralysis or muscle weakness – This typically affects just one side of the body due to the localized brain damage.
- Difficulty walking – This may result from leg weakness, imbalance, or loss of coordination.
- Trouble speaking or swallowing – Speech and swallowing require complex muscle coordination controlled by the brain.
- Vision problems – Strokes can affect visual acuity, peripheral vision, ability to interpret images, and eye movement.
- Memory loss – Strokes in certain areas can wipe out memories or make it difficult to make new ones.
- Emotional problems – Many survivors experience depression, anxiety, personality changes, and uncontrolled laughing/crying.
- Numbness or strange sensations – Strokes can make parts of the body numb or overly sensitive.
- Pain – Nerve damage and muscle strains caused by paralysis and imbalance can result in chronic pain.
- Fatigue – Mental and physical exhaustion are common after strokes.
- Incontinence – Weakened muscles can make it difficult to control the bladder and bowels.
Not all survivors experience these challenges. The extent of disability depends on the part of the brain affected and the severity of injury. With rehabilitation training, many people regain lost abilities over time.
What is the recovery process after a stroke?
Recovering from a stroke is a lengthy process that involves both treatment and rehabilitation. The recovery timeline varies based on the extent of injury. But most stroke patients follow a similar path:
Acute hospital treatment – Patients are monitored closely for days to weeks to manage medical complications. Further brain damage is limited by controlling bleeding, swelling, blood pressure, and infection risk.
Rehabilitation – As the patient stabilizes, doctors begin rehabilitation to help regain function. This may start in the hospital or a specialized rehab facility. Physical, occupational, and speech therapy are common.
Home recovery – The patient continues outpatient rehab and works on adapting their home for safety and independent functioning. Some use mobility aids like wheelchairs or walkers.
Community reintegration – The survivor starts resuming activities like driving, shopping, and social events. Work may be gradually resumed if feasible. Support groups connect survivors.
Long term adjustment – Disability from a stroke is permanent for many. But survivors learn to adapt and maintain quality of life. Routines evolve to deal with lasting effects.
The most rapid recovery occurs in the first 3-6 months post-stroke. But people continue improving for 1-2 years or more. Patience, hard work, support systems, and a positive attitude all help maximize recovery potential.
What lifestyle changes may help prevent another stroke?
About 25% of stroke survivors will have another stroke. So it’s vital to make lifestyle changes to reduce your risk, like:
- Following doctor recommendations for medications. Blood thinners and antiplatelets help prevent clots.
- Controlling high blood pressure with diet, exercise, and medication. High BP is the leading stroke risk factor.
- Lowering cholesterol levels through medication or diet if needed.
- Managing diabetes through healthy eating, physical activity, and medication as required.
- Quitting smoking and avoiding secondhand smoke.
- Exercising regularly to keep circulation and cholesterol optimal.
- Losing excess weight if BMI is over 25.
- Eating a diet focused on fruits, vegetables, whole grains, and lean proteins.
- Drinking alcohol only in moderation, if at all.
- Treating circulation problems like atrial fibrillation to prevent clot formation.
Making heart and brain health a priority through lifestyle habits reduces stroke recurrence risk significantly. Follow up regularly with your medical team as well. Staying on top of medical conditions and adhering to prevention strategies keeps people thriving.
What is the long term prognosis after a stroke?
The long term outlook after stroke depends on the level of disability and medical complications:
- For minor strokes with little permanent damage, most survivors can resume normal activities and independent living within a few months.
- Moderate stroke disability like aphasia or limited mobility may require months to years of adjustment, aids, home modification, and adapted routines.
- Severe disability like paralysis and loss of speech may necessitate intensive, lifelong assistance and care.
Studies show that after 5 years:
- 71% of female stroke survivors are still alive compared to 61% of males.
- 85% are able to walk independently or with devices.
- 80% are able to look after their own personal care and hygiene.
- 70% have adequate cognition to make decisions and engage in social activities.
- 74% report their general health as good to excellent.
So while full recovery is variable, many people regain satisfying quality of life in the years post-stroke. Careful prevention helps maintain gains. Overall, statistics show most survivors can remain active and independent if another stroke can be avoided.
Conclusion
Strokes are medical emergencies that require urgent treatment to save lives and minimize brain damage. Thanks to improved care, about 80% of patients survive their first stroke. Recovery is gradual and varies based on factors like stroke severity, age, rehabilitation commitment, and pre-existing health. Many survivors recover with mild impairments and are able to maintain a good quality of life. While disability cannot be fully reversed, survivors can regain independence through rehabilitation and lifestyle adaptations. Focusing on prevention helps reduce the risk of recurrence. So there is hope of thriving after stroke, especially with today’s medical care, rehabilitation support, and wellness strategies.
