A Guide to Stroke Recovery: diagnosis, treatment, medication and rehabilitation.

Hello there,

As a first aider and a prospective doctor, helping others recover from a health complication and go back to leading a normal life is something important to me.

Last time, I talked about different types of strokes, their causes and consequences, and how to prevent them. Today, I will be informing you about the diagnosis, treatments, medications and rehabilitation related to this cerebrovascular disease.

💡Quick Reminder:

A stroke happens when the blood flow to the brain or part of the brain is interrupted or considerably reduced. This complication stops the brain tissue from getting oxygen and other essential nutrients. In a matter of minutes, brain cells begin to die which often causes permanent damage to the affected person. The blood supply to the brain must be quickly and carefully restored. Strokes are considered as a medical emergency as once the brain cells die, they never regenerate.

Moreover, there are 3 types of strokes: the TIA, the ischemic stroke and the hemorrhagic stroke. For more information, refer to the multiple posts on the blog page on the subject.

Diagnosis.

When someone has a stroke, 911 must be called immediately. As soon as the victim stops facing immediate death, doctors begin to diagnose the patient.

First, they ask about the activities that the patient was doing when the stroke happened. They also note the medications used by the patient (if any), check the blood pressure and listen to the beat of the heart.

Then, a physical exam is required. It evaluates:

• Balance

• Coordination

• Weakness

• Numbness in the body

• Signs of confusion

• Sight

The last step of the diagnosis are some tests. These can attest that the complication is actually a stroke and not something else. They indicate the affected part of the brain, determine if there is any bleeding and sometimes identify the cause of the stroke.

Different tests include:

• Blood tests

These determine blood sugar levels, the presence of an infection in the body, platelets levels and the rate of formation of blood clots.

• MRI(magnetic resonance imaging) or/and CT(computerized tomography) scans

MRIs allow doctors to see if the brain tissue and brains cells have been damaged in any way and CT scans indicate if there is bleeding or any other brain conditions.

• EKG(electrocardiograms)

With the help of the electrical activity in the heart, EKGs measure the rate at which the heart beats and its rhythm. This test can indicate if the stroke happened because of a heart condition like a heart attack or A-Fib.

• Cerebral angiograms

This gives a good look to the arteries in the neck and head area. Blockages and clots can be seen.

• Carotid ultrasounds

This shows fatty deposits in the carotid arteries which supply blood to the head and neck. We can also see if the carotid arteries have been narrowed.

• Echocardiograms

These can detect the origin of blood clots in the heart. Clots can travel to the brain and cause a stroke.

Treatment.

After a good medical evaluation, physicians decide on a treatment. Depending on the type of stroke, the provided medical care will be different.

Ischemic strokes and TIA

These two categories of strokes are treated the same way since they are both caused by blood clotting and blockage

Treatment strategies include:

• Anti platelet and anticoagulants(see medications section)

• Clot-breaking drugs(see medications section)

• Mechanical thrombectomy

This a surgery performed with the help of a catheter. The instrument is inserted in a large blood vessel so that it can grab the clot and pull it out.

• Stents

If the artery walls are weak, a procedure may be performed. It consists of inflating the narrowed artery and support the artery wall with a stent.

• Surgery

If all fails, more complicated surgeries are considered. The surgeon may open an artery to remove the debris struck in there.

Hemorrhagic strokes

They are caused by bleeding or leakage in the brain.

Some techniques to treat this type of strokes are:

• Medications

Unlike ischemic strokes, hemorrhagic strokes demand medications that make the blood clot so that the blood leakage from the vessels can be minimized.

• Coiling

This is a medical procedure where a long tube is inserted at the location of the hemorrhage. A coil-like device is placed to stop blood from leaking, reduce bleeding and strengthen blood vessel walls.

• Clamping

During diagnosis, doctors may discover an aneurysm. To prevent more bleeding, surgeons clamp the base of the aneurysm.

• Surgery

Surgery is always the last resort as it has more risk. A hole and incision might be made on the scalp(craniotomy).

*Make sure to watch these very short animations for a better understanding. They demonstrate these procedures more than my words ever could.

Stroke Medications

Stroke medications often depend on the type of stroke one suffers from. They can be given to treat the stroke or as a preventative measure

As mentioned earlier, for hemorrhagic strokes, blood thinners are usually prescribed to limit bleeding.

Rehabilitation

Strokes are one of the main causes of disability. However, many survivors recover partially or completely with the help of different sorts of therapy. Therapy should start as soon as possible. There are four main of stroke recovery.

1. Speech therapy (speech, langue and verbal communication)

2. Cognitive therapy ( thinking and reasoning skills, control of behaviour and emotions)

3. Relearning sensory skills ( Adjustment to a certain lack of sensation)

4. Physical therapy (regain of strength and balance)

There is obviously so much more to talk about when it comes to treating strokes, but this sums up the most important. I hope that you have learned new things!

See you in my next post

Stay safe 😷

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Work Cited

Healthline[Internet].2018. Holland, Kimberly; [updated 2019 Oct 16; cited 2020 October 23]. Available from:https://www.healthline.com/health/stroke