Strokes occur when blood cannot get to your brain because of a blocked or burst artery, according to the Stroke Foundation. When this happens, the brain cannot get the blood and oxygen it needs, which is a serious medical emergency. It’s critical to get treatment right away to reduce brain damage as well as other complications.
Once a patient is under the care of a healthcare professional, the treatment of a stroke depends on a few things, including the area of the brain that’s involved, as well as the type of stroke, its severity, and the side effects. “People can have weakness, speech difficulties, and numbness,” says neurologist Dr Anna Hohler. “The way we manage these symptoms is based on the wide range of therapies [we have available].”
Here are the stroke side effects that patients deal with the most and how they’re typically treated:
1. Speech difficulties
The frontal lobe of the brain, known as the language center, is often impacted by a stroke. “People can have trouble understanding language, producing the right words, or both,” Dr Hohler says. So, for example, someone may be trying to say something like “put the car in the garage” but it comes out “put the train in the house,”.
How it’s treated: If your neurologist is concerned that your speech or communication skills have been impacted, you may receive a referral for speech therapy. Speech therapists use a variety of techniques to reestablish language functions. “Typically we begin by utilising a communication board that might have pictures on it,” Dr Hohler says. “If a person can’t speak words, they can point.”
These are all steps that are taken to improve your ability to convey your thoughts—even if speech isn’t initially part of that. A speech therapist may also recommend computer programmes and apps that can help you relearn words and sounds between sessions.
2. Weakness
Stroke patients often have weakness in the face, arms, or legs. “You might have trouble holding your arms straight in front of you, you might have a facial droop, or you may have difficulty walking,” Dr Hohler says. Where a patient experiences weakness depends on which blood vessel was blocked during their stroke, Dr Hohler explains. For example, a patient who had a stroke on the right side of their brain may experience weakness on the left side of their body. (Generally, the brain hemispheres control the opposite side of the body; the right hemisphere controls the left side of the body and vice versa.)
How it’s treated: Once a stroke patient’s breathing, heart function, blood pressure, and internal bleeding are stabilised, they may begin physical and occupational therapy. “Physical therapy involves exercises to strengthen the weak portions of the body,” Dr. Hohler says. “Occupational therapy works on improving [things like] dressing, eating, and bathing functions.” These treatments can be done at a doctor’s office if the stroke is mild enough that the patient can return home. If the stroke is more serious, the deficits are usually more profound and the patient typically will require a stay at a rehab center.
3. Spasticity
After a stroke, muscles and joints on one side of the body may become stiff, tighten up and resist stretching. This is called spasticity and about 25 to 43% of survivors experience it in the year following their stroke.
Spasticity occurs when a stroke affects the pathways involved in motor control or muscle tone. “You might end up with a clenched fist or foot that is turned in,” Dr Hohler says.
How it’s treated: Your doctor may want to start with medications or injections. These treatments will help loosen you up enough to do physical therapy, which can help strengthen the impacted muscles.
“We can try [oral] muscle relaxants, and we can inject botulinum toxin,” Dr Hohler says. (Botulinum toxin temporarily helps to relax overactive muscles by blocking the chemical signal between nerves and muscles that makes the muscle tighten.) Individuals whose spasticity is interfering with activities will usually have injections on or near the part of the body that’s most affected, Dr Hohler says. “So, if you have a clenched hand, the injection will be done in your forearm or hand. If your foot is turning in, your injection will be done in the lower leg or foot itself.”
4. Vision difficulties
Vision deficits can result from temporal, parietal, or occipital lobe strokes, Dr Hohler says. There are a number of different vision-deficiency patterns that can develop depending on what part of the brain is affected. Loss of peripheral vision is most common—it can be a loss on the right side, left side, or both.
How it’s treated: If your doctor identifies a vision issue that can be improved, they will likely recommend vision rehabilitation exercises. If the vision issue cannot be improved, the focus will be on helping you adapt to your changes in vision. This may mean “retraining individuals to turn their head to look at a particular side,” Dr Hohler says, rather than relying on peripheral vision.
5. Brain swelling
Also known as cerebral edema, brain swelling tends to occur immediately after a major stroke and can lead to very serious health issues like memory loss, seizures, and difficulty speaking, Dr Hohler says.
How it’s treated: When a stroke patient is in hospital, he or she will experience regular neurological examinations. They’ll also receive intracranial pressure monitoring to monitor brain swelling via a small pressure-sensitive probe that is inserted through the skull. Significant brain swelling that changes the brain’s pressure “is more worrisome and requires intensive monitoring,” Dr Hohler says. “But there are several medications and surgical techniques available to reduce cerebral edema.”
6. Balance and coordination
Having difficulties with balance and coordination are both very common stroke side effects. Both usually occur due to overall weakness but can also be due to damage to the cerebellum, the part of the brain that controls coordination, Dr Hohler says.
How it’s treated: Typically, gait and balance training will be part of these patients’ physical therapy routine, Dr Hohler says. “In addition to strength training, we’ll work on re-centring their centre of gravity, doing core strengthening activities, and getting patients to balance with two feet and coordinate their balance, working to progress to a one-foot balance.”
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