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Stroke

What is a Stroke?

What causes a Stroke?

Who is at risk of taking a Stroke?

What happens during a Stroke?

What are the effects of a Stroke?

Common problems after a Stroke

Treatments

RAMS Therapy Centre and Stroke

Stroke

Every year, an estimated 150,000 people in the UK have a stroke. Most people affected are over 65, but anyone can have a stroke, including children and even babies. Around 1000 people under 30 have a stroke each year. Strokes are the leading cause of disability in the UK with more than 250,000 people living with disabilities caused by a stroke.

 

 

 

 

What is a Stroke?

A stroke occurs when a blood vessel (artery) that supplies blood to the brain bursts or is blocked by a blood clot. Blood carries essential nutrients and oxygen to the brain. Without a blood supply, the nerve cells in that area of the brain become damaged within minutes and die, and as a result, the part of the body controlled by the damaged section of the brain cannot function properly.

Because the brain controls everything the body does, damage to the brain will affect body functions. For example, if a stroke damages the part of the brain that controls how limbs move, limb movement will be affected.

The brain also controls how we think, learn, feel and communicate. A stroke can also affect these mental processes.

 

What causes a Stroke?

 

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A stroke can be caused by:

  • blockage of a blood vessel that supplies blood to the brain. The blockage may be a blood clot that forms inside the blood vessel (throbus) or an object (such as an air bubble or piece of tissue) that moves through the blood from another part of the body (embolus). The most common type of stroke (over 80% of cases) is caused by a blockage. This is called an ischaemic stroke

  • sudden bleeding from a blood vessel that supplies blood to the brain. This is most often caused by the rupture of a weakened area in a blood vessel (aneurysm). This is the second most common cause of stroke, called a haemorrhagic stroke

  • a sudden drop in blood pressure, which reduces blood flow to the brain. Low blood pressure can result from a heart attack, a large loss of blood, or a severe infection

  • high blood pressure, which can damage the delicate lining of blood vessels. Once damaged, fat and calcium can easily build up along the artery walls, forming a plaque. The blood vessel becomes narrowed and stiff (atherosclerosis), and blood flow is reduced

 

Who is at risk of taking a Stroke?

A stroke can happen to anyone, but some people are more at risk. A stroke can happen with no obvious cause to people of any age but there are factors known to increase the likelihood of it happening. Some of these factors are things that can’t be changed. Other risks may be reduced by lifestyle changes or medication.

 

What happens during a Stroke?

When you have an ischaemic stroke the oxygen-rich blood supply to part of your brain is reduced. With a hemorrhagic stroke, there is bleeding in the brain.

After about 4 minutes without blood and oxygen, brain cells become damaged and may die.

The body tries to restore blood and oxygen to the cells by enlarging other blood vessels (arteries) near the area. If the blockage is in a large blood vessel, such as the carotid artery, the body may not be able to supply blood to the affected area through other blood vessels.

If blood supply is not restored, permanent brain damage usually occurs.

 

What are the effects of a Stroke?

A stroke causes damage to the brain, which affects how the body works. Because a stroke is a brain injury, the effects, or symptoms, will depend on the part of the brain that is affected. Every stroke is different and people who have a stroke are affected in different ways.

The effects of a stroke may be mild or severe and temporary or permanent, depending on which brain cells are damaged, how much of the brain is involved, and how quickly the blood supply is restored to the area.  

For some, the symptoms are quite mild and last a short time (just a few minutes or hours in the case of a transient ischaemic attack (TIA) or mini-stroke). Other strokes may cause more severe and lasting damage such as paralysis, coma and even death. When a stroke happens, some brain cells are damaged and others die. Dead brain cells can’t start working again, but those just outside the area of the dead cells may recover as the swelling caused by the stroke goes down. 

It’s also possible that other parts of the brain can learn to take over from areas that have died. Most recovery happens in the first few months, but people can continue to recover for several years after the stroke. 

Different parts of the brain control different parts of the body. The right half of the brain controls the left side of the body and vice versa. Common symptoms like weakness in parts of the body or not being able to use an arm or leg (paralysis) happen on the opposite side of the body to the stroke side of the brain. In most people, the left half of the brain is responsible for language (talking, understanding, reading and writing), and the right half is responsible for perceptual skills (making sense of what you see, hear and touch) and spatial skills (judging size, speed, distance or position in space). 

The effects of a stroke and the degree of functioning that can be regained will depend on:

 

  • which side of the brain was affected (whether it is your dominant side)

  • which part of the brain was damaged by the stroke

  • how much of the brain was damaged

  • your general health before the stroke

 

Common problems after a Stroke

There are several problems or disabilities stroke survivors may face in the first few weeks after having a stroke. Most of these will improve over time as the brain recovers. In severe cases, they may cause long-term disability.

A stroke can cause problems with: -

 

  • Weakness or paralysis: weakness, clumsiness or paralysis (hemiplegia) is one of the most recognisable and most common symptoms of a stroke. It usually happens on one side of the face and body. Weakness or paralysis of an arm or leg is often made worse by stiffness (spasticity) of the muscles and joints. 

  • Balance: unsteadiness (loss of balance) can be caused by damage to the part of the brain that controls balance. Or it may happen because of paralysis resulting in muscle weakness.

  • Swallowing: about 50% of people have difficulty with swallowing after a stroke (dysphagia). This can be dangerous if food goes down the wrong way and gets into the windpipe.

  • Sleep and tiredness: most people suffer from extreme tiredness (fatigue) in the first few weeks after a stroke. Many also have difficulty sleeping, which makes them even more tired.

  • Speech and language: many people experience problems with speaking and understanding, and with reading and writing. This difficulty with language is called aphasia. When a person finds it hard to understand what is being said, it is called receptive aphasia. Sometimes a person may understand what is being said but can’t find the right words to express what they want to say. This is called expressive dysphasia. People often have a mixture of both types of aphasia.

  • Eyesight: a stroke can damage the parts of the brain that receive, process and interpret information that the eyes send. Sometimes, people who have had a stroke may have double vision or lose half of their field of vision. They can see everything over to one side but are blind on the other. This can cause clumsiness and seemingly odd behaviour (like not eating food on one side of a plate).

  • Perception and interpreting: people may have difficulty recognising familiar objects or knowing how to use them. They may also have problems with skills like telling the time if the brain can’t interpret what the eyes see.

  • Mental processes: a stroke often causes problems with mental processes such as thinking, learning, concentrating, remembering, making decisions, reasoning and planning. People may lose short-term memory, which makes it difficult to pay attention and concentrate.

  • Bladder and bowels: difficulty controlling the bladder and bowels (incontinence) is not unusual after a stroke. Most people regain control in a few weeks.

  • Mood swings: emotional ups and downs are very likely after a stroke. Depression, sadness, anger, anxiety, low self-esteem and loss of confidence are common. Sometimes, people find it hard to control their emotions and may cry, swear or laugh at inappropriate times. They may find that their inhibitions are lifted and their behaviour seems out of character.

  • Sensation: some people have problems with sensation; they feel too much or too little. They may be very sensitive to colour, sound and light. Or they may not feel painful sensations like heat or sharp objects which can cause accidents and injuries.

  • Pain: pain can be caused by the stroke (for example, shoulder pain and spasticity), or may be caused by problems the person had before the stroke being made worse.

 

Treatments

 

A stroke involves a lot of immediate medical treatment and sometimes months or years of ongoing rehabilitation.

Prompt treatment of stroke and medical problems related to stroke, such as high blood sugar and pressure on the brain, may minimize brain damage and improve the chances of survival. Starting a rehabilitation program as soon as possible after a stroke increases your chances of recovering some of the abilities you lost.

Initial treatment for a stroke varies depending on whether it's caused by a blood clot (ischemic) or bleeding in the brain (hemorrhagic). Before starting treatment, your doctor will use a computed tomography (CT) scan of your head and possibly magnetic resonance imaging (MRI) to diagnose the type of stroke you've had. Further tests may be done to determine the location of the clot or bleeding and to assess the amount of brain damage. While treatment options are being determined, your blood pressure and breathing ability will be closely monitored, and you may receive oxygen.

Initial treatment focuses on restoring blood flow (ischemic stroke) or controlling bleeding (hemorrhagic stroke). As with a heart attack, permanent damage from a stroke often develops within the first few hours. The quicker you receive treatment, the less damage will occur.

Longer term treatment strategies include drug therapies such as antihypertensives; physiotherapy, flowtron therapy, massage and rehabilitation; hyperbaric oxygen therapy; electromagnetic therapy; vibrotherapy and complementary approaches to releive symptoms, improve body function, minimise disabilities and regain as much independence as possible.

 

 

RAMS Therapy Centre and Stroke

 

 

RAMS Therapy Centre provides a range of therapies, designed specifically for Stroke. Follow the links below for further information on these treatments. Therapies will be provided individually as stand-alone treatments or offered in combination. Each person will be assessed and advised on a suitable treatment programme.

Note: permission from your doctor or consultant is required before treatment begins.

                                               Hyperbaric Oxygen Therapy

           Physiotherapy

        Flowtron Therapy

            Electromagnetic Stimulation Therapy

             Vibrotherapy