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Stroke Recovery: Dealing with Long-Term Disability After a Stroke

Research on stroke recovery has the power to improve outcomes and support people as they navigate life post-stroke.

 

Stroke is a disease that occurs when the brain’s blood supply is interrupted as the result of a blood clot or hemorrhage. Every year, more than 800,000 people in the U.S. experience stroke, and 140,000 people die from the disease.

Stroke is the leading cause of permanent disability in adults. After a person experiences a stroke, their life can change drastically and they may not be able to live the same way they did before. This brain disease often greatly impacts the individual as well as their family and loved ones.

Stroke recovery presents many challenges. At the American Brain Foundation, we’re committed to research that can help improve the recovery process and its outcomes. It’s important to support people recovering from a stroke so they can have more independence and live their lives closer to how they did before the stroke.

What Causes a Stroke?

There are two types of stroke: ischemic and hemorrhagic. An ischemic stroke happens when the blockage of a blood vessel stops blood supply to the brain, depriving it of the oxygen and nutrients it needs. A hemorrhagic stroke occurs when bleeding from a ruptured blood vessel causes pressure to build in the brain, harming or killing brain tissue.

The best treatment for stroke is prevention. Some risk factors like high blood pressure, diabetes, and smoking can be treated through medication and lifestyle changes.

Other risk factors, such as age, sex, race, and medical history, cannot be changed. People who have had a stroke, transient ischemic attack (TIA), or heart attack, or those who have an immediate family member who has had a stroke, are at increased risk. Risk increases with age, approximately doubling for each decade of life after age 55.

What Happens When You Have A Stroke? 

It is important to recognize the signs of stroke so you can help yourself or your loved one get immediate medical care. A stroke can cause permanent brain damage, resulting in paralysis, cognitive problems, emotional control problems, and depression. The quicker a person having a stroke can receive treatment, the lower the risk of long-term brain damage and the higher the chance of a positive outcome.

The main warning signs of a stroke include sudden loss of balance and coordination, vision problems, paralysis or numbness in the face, arm, or leg (especially on one side), and slurred speech. Other common signs are confusion, dizziness or vertigo, severe headache, or trouble speaking, seeing, or walking. The acronym BE-FAST is a tool to help people remember and identify stroke symptoms:

Balance – Sudden dizziness or loss of balance and coordination

Eyes – Difficulty seeing

Face – One side of the face is drooping

Arm – Can’t lift their arm or are experiencing weakness or numbness in the arm or leg,       especially on one side of the body

Speech – Slurred speech or is unable to talk

Time – React right away and call 911

Research advancements in stroke treatment have expanded access to immediate medical care. In 2014, James C. Grotta, MD, a neurologist and clinical researcher on the American Brain Foundation’s Research Advisory Council, launched the nation’s first Mobile Stroke Unit (MSU). The MSU is a modified ambulance containing brain imaging equipment like a portable CT scanner and tPA “clot busting” medications. 

Now, lifesaving mobile stroke units are able to provide early response treatment directly to a person having a stroke. This accelerated process saves over 30 minutes of time and generates 10 times more treatments within the first hour compared to standard stroke management, leading to better clinical outcomes. Ongoing research by doctors like Alexandra Czap, MD continues to expand treatment protocols and show the impact of MSUs on stroke outcomes.

What Happens After a Stroke? 

After a person is diagnosed with stroke, what does stroke recovery look like? Stroke recovery includes therapy during an acute attack and post-stroke rehabilitation.

During an acute attack, treatment involves dissolving a blood clot in the case of an ischemic stroke or controlling bleeding in the case of a hemorrhagic stroke. Catheter- or IV-based treatments or minimally invasive surgeries may also be used.

Post-stroke rehabilitation may include a combination of different therapies, such as:

  • Physical therapy for regaining strength and mobility 
  • Occupational therapy for regaining skills to live as close to independently as possible 
  • Speech therapy to address speech, language, and swallowing issues 
  • Cognitive therapy to improve memory
  • Counseling to treat psychological effects

Outcomes often depend on how quickly a person is treated and how much brain damage occurred. Neurodisparities and socioeconomic factors also play a role in how someone recovers from a stroke. Next Generation Research Grant recipient Dominique Popescu, PhD, is currently researching the effects of social and psychological determinants, such as social isolation, stress, and depression, on stroke recovery. 

Relatedly, research shows that Black people are more likely to have more severe strokes and less likely to survive them, compared to white people. A person’s environment – everything from air quality and food accessibility to housing and transportation – can impact their stroke risk and underlying disease severity, as well as their access to recovery services.

Life After Stroke

After a stroke, many people live with some degree of disability, requiring major changes to their day-to-day life. For stroke survivors like Debra Meyerson, recovery is much more than the physical challenges — it also involves a change in identity.

Even after three years of intensive rehabilitation, a severe stroke left Debra with a limp, no function in her right arm, and limited speech. She had to give up her tenured position as a professor at Stanford University. These changes put her on a painful journey of rebuilding her identity as she transitioned from scholar to stroke survivor.

To improve life after stroke, we need further research. The work of Next Generation Research Grant recipient Margy McCullough-Hicks, MD, is a key example of research that can promote more effective treatment. Dr. McCullough-Hicks’s project aims to personalize an individual’s predicted outcome following a thrombectomy, a highly effective stroke therapy that currently isn’t used often because its benefits for stroke symptoms are difficult to predict.

The American Brain Foundation supports stroke research from acute treatment all the way to recovery. These discoveries can help people recovering from stroke have more independence and a life that looks more like their life pre-stroke. Through research, we can gain a better understanding of the many factors involved in stroke recovery — physical, environmental, emotional. We can offer greater hope and support to people recovering from this life-altering brain disease.

The American Brain Foundation knows that when we find the cure to one brain disease, we will find cures to many others. Learn more about the brain disease research we fund. Donate today to support the cures and treatments of tomorrow.