Recovery from stroke does not happen quickly or easily. For many, rehabilitation can be a lifelong process. All facets of the human person are involved in post-stroke recovery, including the restoration of mental, physical, and emotional functions. But whether the patient has suffered a hemorrhagic stroke, an ischemic stroke, or a mini-stroke, there are treatments available that can reintegrate body and mind, restoring the experience of a normal, functional life.
A stroke is a very serious condition that occurs whenever the blood flow to a part of your brain is cut off by blood clots or broken blood vessels. Strokes are similar to heart attacks in the sense that both are vascular events (involving the blood vessels), and are two of the most life-threatening challenges the body faces. However, while a heart attack is typically the result of progressive coronary artery disease where the arteries that supply blood to the heart become choked with fat, a stroke is more like a “brain attack” in that it affects the brain rather than the heart.
Recovery from stroke depends largely on knowing the kind of stroke that a patient suffered. An ischemic stroke is what happens when the flow of blood to the brain is prevented by a blood clot. A transient ischemic stroke, also known as a “mini-stroke,” is caused by a temporary clot and may lead to a major stroke. (Recovery in this instance necessitates preventing the even bigger stroke to which the mini-stroke may have been the prelude, often through a drastic change in diet and lifestyle).
A hemorrhagic stroke is a type of stroke that occurs when a brain vessel in the brain bursts and bleeds, depriving the brain of blood and causing significant internal damage. Hemorrhagic strokes are one of the most severe kinds of strokes and require the longest period of recovery of stroke patients. The reason they’re so dangerous is because the leaking of blood into the brain can lead to deadly conditions like hydrocephalus (a buildup of fluid inside the skull that leads to brain swelling), intracranial pressure, and blood vessel spasms, all of which require urgent and immediate care; otherwise, the patient may develop brain herniations or severe brain damage. They may even die. Even the smallest amount of bleeding in the cranium demands the care of a trained neurosurgeon.
Whatever the cause, strokes may significantly impair a person’s physical well-being and emotional/cognitive functions in a number of ways. Having a stroke can result in visual disturbances such as visual field loss, where the patient develops blind spots in his or her field of vision. (One common type of vision loss is hemianopia, the loss of vision in half of each eye). Depending on where in the brain it occurs, a stroke may inflict balance and posture problems, disorientation, lack of concentration, and trouble blinking.
Sleep may also be impaired in a number of ways. One of the most common is sleep-related breathing disorders, in which the patient breathes irregularly or intakes air in abnormally low amounts. The most common sleep-related breathing disorder in stroke victims is obstructive sleep apnea (OSA), in which the body’s air passages close during sleep, causing the victim to stop breathing. She must then fully awaken in order to reopen the clogged passage and resume normal breathing. OSA is not only an after-effect of stroke, but also a major risk factor for another stroke. It is most common in stroke survivors who have suffered multiple strokes. Other sleep disorders often experienced by stroke victims include sleep-wake cycle disorders (suffered by 20 to 40 percent of stroke survivors), where the internal body clock does not align with normal sleep cycles, and insomnia.
Stroke is the most common cause of seizures in the elderly, and about 10 percent of all stroke survivors experience a seizure following a stroke. Stroke survivors who have hemorrhagic strokes are more likely to have at least one seizure within 24 hours. If a stroke patient suffers chronic and constant seizures following a stroke, then he or she may be diagnosed with epilepsy.
Other symptoms known to affect stroke victims include: incontinence (over 40 to 60 percent of patients report having trouble controlling their bowels during recovery); one-sided paralysis (hemiplegia) or one-sided weakness (hemiparesis), resulting in paralyzed or weak limbs or loss of control of the facial muscles or bladder; locked-in syndrome, a rare condition in which the patient can only move his or her eyes; spasticity, characterized by stiff muscles; dysphagia, paralysis of the throat muscles; foot drop, in which the patient can’t raise the front part of the foot; and physical, cognitive, and emotional fatigue.
Recovery for stroke victims begins within the first couple of days after being admitted into the hospital. For patients who are already stable, rehabilitation begins within 48 hours and should be continued by whatever means necessary upon release from the hospital. Depending on the severity of the stroke, this may include a rehabilitation clinic in the hospital, a stroke recovery center, home therapy, or a long-term care facility offering skilled nursing care.
Currently there are about seven million people in the United States living with the after-effects of a stroke. While 10 percent of stroke survivors recover rapidly and completely, and another 15 percent die shortly after having the stroke, the majority of survivors will have to decide the kind of care they need.
Studies show that those with limited access to health care will experience precipitous decline in the five years following their stroke. Even those who initially showed significant improvement may demonstrate severe loss of function. That is why, for many, the best available means of support will be a stroke recovery center such as the Stroke Prevention and Recovery Center at John Hopkins University or the Kessler Institute for Rehabilitation. These facilities are equipped to handle patients suffering traumatic brain injury and transient ischemic attacks (TIAs) through exercise, speech therapy, advanced equipment technology, and on-site case management. Those undergoing ischemic stroke recovery and ministroke recovery may find this the wisest option, because experienced care teams are always on-hand to assist them in relearning skills for their everyday life.
For those who can afford it, home care is a viable and popular method of stroke recovery. Specialists agree that the support of a family is one of the most critical factors in ensuring the long-term restoration of a person’s health. “Family acceptance is crucial in helping a person understand that just because he or she needs assistance is no reason to feel ashamed or unworthy,” says Dr. Charles E. Levy. And in fact, most types of therapy can be done outside the hospital, in the safety of the patient’s own home. Whether you can convalesce at home ultimately depends on whether and how much you can take care of yourself, whether there will be others to support you, and whether the home is a safe environment, but for those who choose to undergo the brunt of their rehabilitation at home, there may be dramatic changes in the way the household operates. Bedrooms and bathrooms should be rendered easily accessible at all times, while items such as throw rugs that can cause falls should be removed to prevent the threat of injury. There are also electronic devices that can be purchased that may help in the performance of ordinary household tasks such as cooking, cleaning, bathing, showering, moving from one room to another, writing, and using a computer.
But wherever the patient chooses to reside, full recovery from stroke may necessitate one or more of the following options: speech therapy; strengthening of motor skills to improve strength and coordination; mobility training (learning to walk with the aid of walkers, canes, or plastic braces); motion therapy to lessen spasticity and regain range of motion; psychological evaluations; counseling with mental health professionals; the use of medicines to stabilize moods; electrical stimulation to stimulate weakened muscles; and constraint-induced therapy, in which the patient restricts the use of one limb while rehabilitating the use of the other.
For those seeking full recovery from stroke, help is available at the New York DNR.
We use Vojta therapy to decrease spasticity in patients with partial paralysis . Vojta therapy allows recovery of neurons responsible for use of muscles affected by stroke . Our practice utilizes advanced CAREN (Computer Assisted Rehabilitation Environment), a breakthrough technology for treating balance and walking disturbance in post stroke patients.CAREN is the most advanced CAREN (Computer Assisted Rehabilitation Technology) is only now being made available to civilians, affected by stroke and brain damage. The New York DNR is currently the only facility in New York offering this treatment.
Those seeking physical recovery from hemorrhagic stroke will benefit from our Gait Lab, which offers a one-of-a-kind, multidimensional examination and treatment of all the aspects involved in walking. So whether you need physical rehabilitation or right brain recovery, our facility possesses the equipment to administer both physical rehabilitation and stroke therapy as well as cognitive therapy . We offer the most comprehensive post stroke treatment in New York City.
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