Stroke Identification, Prevention and Rehabilitation

What I am about to discuss with you is not the most exotic topic, but it is one that effects a significant part of the population. Strokes, even if you do not know someone personally who has one you still probably have a vague idea what they are.

Strokes occur every 40 seconds in the united states and are the fifth leading cause of death in the united states. In this country a person dies every 4 minutes from a stroke. It also happens to be one of the leading causes of adult disabilities. What I would like to teach you today is how we as individuals and as a nation more effectively prevent, identify and help those who suffered from stroke recover.

The question we must address first is what is a stroke, and how can we identify it as non medical professionals? According to the mayoclinic a stroke occurs when blood flow to certain areas of the brain are cut off and begin to die. These strokes can be hemorrhagic, this type of stroke appears when a blood vessel in the brain leaks or ruptures. This type of stroke is often cause by high blood pressure.

There are also Ischemic stroke, these account for about 85% of strokes and are mostly preventable. These are cause by fatty deposits blocking blood supply to the brain, this could begin in the brain or in another part of the body and move into the brain causing the stroke.

Lastly there are TIA’s or ministrokes, these last for only a few minutes but does put a person at a greater risk for a stroke. In the future.

Symptoms of strokes include but are not limited to, trouble speaking, paralysis of the face, arm or leg especially on one side of the body, trouble seeing, headache and trouble walking.

To help you identify a stroke use the fast method.

· Face: Ask them to smile, does one side droop?

· Arms: When the raise both arms does on drift downward?

· Speech: Does it sound slurred?

· Time: If any of these are a yes call 911 immediately and administer aspirin to prevent clots from forming.

Time is crucial. The longer the person goes untreated the worse the long-term effects are. Healthcare professionals only have a 4.5 hour window to provide the patient with a clot buster that could save the patients life.

This may get you thinking, what if they don’t get to the hospital in time? How can the patient recover?

The answer is, they don’t always recover and in some cases die. To those who survive a stroke the road to rehabilitation is long. In all honesty most stroke patients only typically regain 60-70% of their abilities back. Most of rehabilitation for stroke survivors is learning to cope with their new disability.

In the future rehabilitation looks much more promising. In a study done by Johns Hopkins University using mice it has been shown that having an enriching environment aids in rehabilitation.

It also looks as though the time after a stroke the entire brain chemistry changes. In adulthood our brains have a normal amount of learning power, they are not as absorbent as say a child’s brain but we can still learn.

Have you ever given an older person a iPod or smartphone and told them to try it? How about when you give it to an 8 or 9 year old? What difference do you see?

The child will always pick up on the technology first because their brain has more plasticity, or learning power. It seems as though after a stroke a person has a unique time in which the brain increases in plasticity.

The problem is our healthcare system is not capitalizing on this. Instead of using this time and pushing the patient into rehabilitation we let them sleep, watch tv and mostly stay alone in a hospital room. By doing this they are losing valuable time to regain the abilities they might have lost.

In mice it seems as though when they were driven immediately after the stroke to learn again they recovered almost fully. Vs the mice who did not start rehabilitation right after the stroke who did not fully recover. This instant rehab after stroke may help completely rewire the brain and bring stroke victims almost completely back to normal. In clinical trials the use of video gaming coupled with movement training may be very promising to the world of stroke rehabilitation. Making therapy fun itself may lead to increased benefits for those in rehabilitation therapy.

As of now the key to surviving a stroke is quick identification. But why deal with the after effects of a stroke when for the most part they are preventable. Most strokes are preventable by good diet, exercise and maintaining a normal blood pressure.

In the future when we understand how to capitalize on the brains healing we could give those who have strokes a better and faster recovery. But for now we must rely on prevention, identification and rehabilitation.