May is American Stroke Month. Although experts estimate that 80% of strokes are preventable, stroke remains one of the leading causes of long-term disability in the U.S. The American Stroke Association sponsors the month to spread awareness about the warning signs of stroke and what to do if you suspect someone is having a stroke, including yourself.
Strokes occur when there is a blockage or rupture of a blood vessel that brings blood and oxygen to the brain, killing the brain cells and resulting in many post-event challenges with movement, thinking, and speaking. These effects can be temporary or permanent, largely dependent on how many cells are lost.
How do you know if you are having a stroke? Just remember the acronym F.A.S.T.:
F.A.S.T. is more than a clever acronym; it’s also good advice. According to the American Stroke Association, “nearly two million brain cells die each minute a stroke goes untreated.” Acting quickly can reduce the damage caused by the loss of your brain’s blood and oxygen flow. A Canadian woman, Stacey Yepes, had been having stroke-like symptoms, so she went to see her doctor. He found no evidence of a stroke in his testing and told her it was stress related. When it happened again, she took a video of her symptoms:
Stroke warning signs are as follows:
- Weakness or Numbness of the face, arm or leg that suddenly occurs, usually concentrated on one side of the body.
- Confused thinking and cognitive ability
- Sudden difficulties speaking
- Vision problems in one or both eyes that occurs abruptly
- Challenges walking and with coordination
- Dizziness or balance issues
- A sudden headache with no known cause
For more information on the warning signs of Strokes, please download this PDF from the American Stroke Association.
Why the Damage Occurs
What happens to the brain when a stroke occurs was not understood for many years. Experts knew that Strokes (as well as other brain injuries and conditions such as seizures, schizophrenia, and Traumatic Brain Injuries) cause acidity in the brain, but why that affected the brain’s function wasn’t known. However, a new study from the University of Buffalo discovered an inactive brain receptor (called N-methyl-D-Aspartate, or NMDA) reactivates as a result of an increase in acid that occurs. When NMDA receptors reactivate, they cause the neurons to become more sensitive than usual to particular amino acids. In this case, they are responding to the neurotransmitter glutamate, the amino acid involved in the majority of our normal brain function, like reasoning, memory, and learning. Within specific conditions, this sensitivity can kill them. Understanding how the damage happens is a significant step toward developing a way to prevent it.
Unfortunately, at this time, there is no way to prevent the damage caused by strokes that create challenging symptoms for the patient. From weakness or paralysis on one side of the body to speech problems, to emotional, behavioral and cognitive changes, and more, there are many effects a stroke can leave behind. All of these changes result in common psychological effects, including depression, apathy, frustration, anger, sadness, denial, and mood swings. While these effects are the acutest immediately following the stroke, many people improve over time.
To learn more about the consequences of stroke, please download this PDF from the American Stroke Association.
Recovering from a stroke
Patients recovering from a stroke should participate in a stroke rehabilitation program. Stroke rehabilitation programs, or Stroke Rehab, help regain the skills lost. The goal is to help the patient remain independent and have the best possible quality of life. It begins within 24-48 hours after the stroke occurs and could last any amount of time, ranging from weeks to months, and, in some cases, years.
Stroke rehabilitation takes many forms depending on the patient’s needs. However, they often include some mix of the following types of therapy:
- Motor Skills Training: Exercises facilitate improvement in coordination and strength for muscle groups, including those involved in swallowing.
- Mobility Training: Relearning how to walk, often with the help of walking aids, like a walker or canes.
- Range of Motion Therapy: Exercise and other treatments help patients reduce muscle tension that can cause spastic movement, and regain their range of motion.
- Communication Treatment: Using therapy to help patients learn to speak, listen and comprehend again.
- Emotional Therapy: Helping patients adjust to the emotional swings and disturbances this new reality can cause, teaching them ways to cope and manage their symptoms.
Psychological effects have a significant impact on the patient’s Stroke Rehab success. Learning to control emotions and talk about the feelings they have after a stroke is an excellent way to help facilitate the Stroke Rehab’s best possible outcome.
To learn more about the emotional changes after stroke, please download this PDF from the American Stroke Association.
A formal cognitive assessment by a licensed Neuropsychologist assesses the emotional and cognitive disorders a patient might experience. Neuropsychological evaluations help create a stroke rehab that addresses the specific needs of the patient’s cognitive and emotional well-being. Working with a Neuropsychologist, patients recovering from strokes along with their support group of friends and family can improve the stroke rehabilitation process.
For a more detailed look at how Stroke Rehab helps patients, please download the PDF from the American Stroke Association.
Dr. Walden has over a decade of experience in neuropsychological assessment and treatment of adults and children. He has extensive expertise in the evaluation and treatment of chronic and acute mental and behavioral health concerns. Dr. Walden provides neuropsychological assessment, psychological testing, and psychotherapeutic services at Achieve Wellness Group. He is presently accepting new patients.
“Stroke Hero.” www.strokeassociation.org. Web. 17 May 2016. <http://www.strokeassociation.org/STROKEORG/AboutStroke/AmericanStrokeMonth/American-Stroke-Month_UCM_459942_SubHomePage.jsp>.
University at Buffalo. “Finding sheds light on what may kill neurons after stroke: Discovery paves the way for highly specific drug target for strokes, brain injuries.” ScienceDaily. ScienceDaily, 29 April 2016. <www.sciencedaily.com/releases/2016/04/160429105537.htm>.
“Stroke Rehabilitation: What to expect as you recover.” www.mayoclinic.org. Web. 17 May 2016. <http://www.mayoclinic.org/stroke-rehabilitation/art-20045172>