I’ve had a Stroke! Now what?

What causes a stroke and what can be done to return to normal function?

Written by Greta Myers, DPT

Article

What is a Stroke / CVA?  

A stroke occurs when there is a lack of blood flow to an area of the brain.

The blood flow to the brain is crucial to its function. Blood provides the nutrients that the brain needs. These blood vessels flow to all portions of the brain to ‘drop off’ the nutrients. The vessels are different sizes with smaller vessels tending to provide nutrients to a smaller portion of the brain while larger vessels provide nutrients to a larger portion of the brain. The body also has a backup plan in case something happens to one of them (i.e., stroke). The areas where they provide nutrients tend to overlap, like a Venn diagram. If an area of the brain is unable to get the blood flow and therefore unable to receive the nutrients it needs, that area of the brain will be damaged and unable to function.

There are two main types of strokes:

Ischemic Stroke There is a blood clot that prevents the flow of blood to the brain.

Ischemic Strokes account for 87% of strokes.2 These blood clots can occur for various reasons including atherosclerosis (hardening of vessels) or embolism (a blood clot gets dislodged from another area of the body and then gets stuck in a vessel in the brain). Typical treatment is either mechanical surgery to remove the clot or, if the response is fast enough, medication to break up the clot.

Hemorrhagic Stroke: A blood vessel has broken and is bleeding in the brain.

This type is less frequent, occurring in only about 13% of strokes.3 The blood vessel is usually in a weakened state. This could be caused by high blood pressure or an aneurysm. Blood is then pushing on the brain which causes damage and prevents the blood from delivering nutrients appropriately.

Effects of a Stroke:  Stroke presentation will depend on the location of the stroke, which can occur in various sections of the brain:

  • Frontal Lobe: Controls planning, problem solving, self-control, organization, and movement and well as the ability to speak
  • Parietal Lobe: Controls your somatosensory integration or your comprehension of pain, touch, temperature, and proprioception
  • Temporal Lobe: Regulates memory, your ability to understand language, and hearing
  • Occipital Lobe: Vision centers are located here
  • Cerebellum: Helps with coordination, vestibular system and balance

Depending on the location of the reduction in blood flow, different aspects of the body can be affected. For example, if there is a blood clot in the frontal lobe, you may have difficulty with moving your arms or your legs and controlling your movements such as transfers, walking, or stairs.

The brain can also be divided into the left and right halves, or hemispheres. Most of the neurons on the left side of the brain are wired to control the right side of the body and the right side of the brain to the left side of the body. Therefore, if you have a stroke on the left side of your brain, you are more likely to have more weakness, decreased sensation, or other impairments on the right side of your body.

So what should you do if you or a loved one has had a stroke?

Therapy can help!  There are multiple types of therapy that can be beneficial for those who have suffered a stroke:

  • Speech Therapy can help with swallowing, speech, and cognition.
  • Occupational Therapy can specialize in vision, work on cognition, and hobbies/daily tasks.
  • Physical Therapy will be help regain function and control over your muscles, help to restore your balance and gain strength.

As a physical therapist, I am passionate about the role of physical therapy in stroke recovery. Physical therapy can improve your strength and movement in your arms, legs, and trunk and improve your ability to walk, transfer, and balance. Physical Therapists will train you to properly use any necessary durable medical equipment and adaptive equipment. Physical therapy can also prevent secondary impairments and work with your family/caregiver to ensure everyone’s safety.

Depending on the level of dysfunction, it may prove prudent to seek out a physical therapist who specializes in neurological rehabilitation.  When scheduling, be sure to ask if there is a therapist who treats neurological patients regularly or has further training including Neurological Clinical Specialist (NCS) or Certified Stroke Rehab Specialist (CSRS).

Seek Community Support:  Another important step on your road to recovery is to get involved in your community. You are not alone in this journey. Staying connected with friends and family can be beneficial. Finding a support group for the survivor, caregiver, or both can help you as you transition to a different lifestyle. These groups can also provide more resources for the survivor or caregiver to help with equipment, education, or navigating returning to activities. Finding people who support you is crucial to returning to the life you want.

The brain is complicated, and we are here to help! Please email Greta Myers, Neurological Physical Therapist, with any questions as you are navigating these changes if you or a loved one has had a stroke.