Stroke
- Physical Therapy International Service
- 12 minutes ago
- 5 min read
Authors: Ella Bonner, Livi Kovach, Anna Norton
A stroke is a medical emergency that occurs when there is an issue with the arteries and other blood vessels that supply blood to different parts of the brain so that they are able to carry out their functions for the body. Without emergency medical treatment, a stroke can lead to brain damage and other complications. The most common type of stroke is an ischemic stroke. This type of stroke occurs when there is reduced or blocked blood flow to the brain from its blood vessels. These vessels can become narrowed or completely blocked due to fatty deposits, blood clots, or other debris. When these vessels become blocked, this leads to reduced blood flow to the brain, causing the stroke to occur. Another type of stroke is hemorrhagic stroke. This type of stroke is caused by the rupturing or leaking of a blood vessel in the brain. This leads to bleeding in the brain, which can cause the stroke to occur. Some factors that may lead to the rupturing of brain blood vessels are uncontrolled high blood pressure, aneurysms (bulges caused by weak spots in the walls of the blood vessel), overuse of blood thinners, head trauma, and an ischemic stroke leading to a brain hemorrhage or bleed.
The Carotid Arteries and the Vertebral Arteries are the two major pairs of arteries that supply blood to the various areas of the brain. The Carotid Arteries can be found along the front of your neck, and a stroke in these arteries would lead to vision, sensation, and speech problems. The Vertebral Arteries can be found along the back of your neck, and a stroke here would lead to movement, vision, and speech changes. As these two pairs of arteries travel towards the brain and give off other branches, they meet at the base of the brain and form a circle of arteries that increases the number of paths to supply the brain with blood, the Circle of Willis. The main arteries of the Circle of Willis that could be affected by a stroke are the Anterior Cerebral Arteries (ACA), Middle Cerebral Arteries (MCA), and Posterior Cerebral Arteries (PCA). The ACA supply blood to the frontal lobe of the brain, and a stroke in these arteries would cause personality changes, difficulty thinking, and/or leg weakness. The MCA supply blood to the middle parts of the brain including the temporal and parietal lobes, and a stroke in these arteries would cause language problems, one-sided paralysis, blindness, and/or vision problems. The PCA supply blood to the back of the brain including the occipital, temporal, and parietal lobes, and a stroke here would cause vision problems.
Every stroke affects people differently but there are common responses to strokes based on their location in the body. When you have a stroke in the left side of the brain, this can result in functional loss in the right side of the body such as paralysis, changes in sensory information receival, but then also can affect speech, language, abstract thinking, memory, and can cause slow and cautious behavior. When a stroke happens in the right side of the brain, this similarly can lead to paralysis and sensory information dysfunction but in the left side of the body. On top of this, you can also have vision problems, issues with imagery, and can see quick movement occur. If the stroke is in the brain stem, you may see paralysis in the entire body leading to what is known as a “locked-in” state. This is where a patient cannot move or speak other than blinking and moving their eyes back and forth.
FAST signs are the common warning signs of a stroke and include Face drooping especially when the person is smiling, Arm weakness with touch or one arm may drift down if asked to lift both, difficulty with Speech like being slurred, and the T means its Time to call 911 for the person. Other than the FAST signs, a person may experience numbness on one side of the body, confusion with speech or understanding others, vision issues, loss of balance while walking, or can be experiencing a bad headache with no cause. When someone is having a stroke, it is extremely important to call 911 as early treatment can save brain cells in the person lowering rates of disability after the stroke. When calling 911, it is important to write down or remember the timing of the symptoms because this can help determine how to treat the person. While waiting for the ambulance, you should try to keep the person calm and lay them down on their side with their head elevated.
A transient ischemic attack (TIA), sometimes called a “mini stroke”, happens when blood flow to a part of the brain is temporarily blocked. Unlike a full stroke, the symptoms of a TIA usually are shorter, lasting a few minutes to a few hours, and do not cause permanent brain damage. Common TIA symptoms include temporary weakness, numbness, difficulty speaking, or vision changes in one side of the body. Experiencing a TIA is a major warning sign that a person is at a higher risk of having a full stroke in the near future. Studies show that about 10-15% of people who have a TIA will have a stroke within three months.
Immediate treatment for a stroke depends on the type of stroke. For ischemic strokes, doctors may use clot-busting medications of mechanical thrombectomy to restore blood flow, while hemorrhagic strokes often require surgery or procedures to stop the bleeding and relieve pressure on the brain. After acute treatment, rehabilitation begins, often starting in the hospital. Inpatient rehabilitation focuses on regaining movement, speech, and daily function through physical, occupational, and speech therapy. Once patients are stable, outpatient rehabilitation continues at clinics or at home, focusing on improving independence, strength, and cognitive function. Early and intensive rehab has been shown to improve long-term recovery and reduce disability after a stroke.
The long-term consequences of a stroke vary depending on the area of the brain affected and the severity of the stroke. Physical effects can include paralysis or weakness on one side of the body, difficulty with balance and coordination, and chronic pain. Cognitive and emotional changes may also occur, such as memory loss, difficulty concentration, depression, and personality changes. Some people experience ongoing difficulties with speech and language or have trouble performing daily activities independently. The impact on a person's life can be significant, often requiring long-term support from family, caregivers, and rehabilitation services.
A stroke is a very serious medical emergency caused by issues with blood supply to the brain. There are two main types of strokes: ischemic and hemorrhagic. Strokes need to be treated immediately or they can lead to serious brain damage and other complications. Different brain functions can be altered based upon what area of the brain is affected. It is important to know the signs of a stroke so that you are easily able to identify them and get help. Treatment and physical therapy can be very beneficial for those who have suffered from a stroke. The goal of treatment for a stroke is for the patient to regain normal function and daily activities.
Resources:
Comments