Stroke Recovery: What to Expect

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Stroke recovery is an ongoing process, and the results will vary from person to person. Some people might recover from a stroke in a few days, while other stroke survivors continue to improve over a number of years. It’s possible for stroke to be a diagnosis with positive outcomes.

“Many patients do very, very well. Over half the patients we see, for example, go home after the stroke,” says Harold Adams, MD, Professor of Neurology at the University of Iowa Healthcare and Director of the Division of Cerebrovascular Disease, Neurology and the Comprehensive Stroke Center. “There are stroke survivors that are absolutely independent who are doing all sorts of activities.”

Effects of a stroke

The short- and long-term effects of a stroke depend on the location and severity of the stroke. Each side of the brain controls the opposite side of the body and different physical functions, so someone who has had a stroke on the right side of the brain may experience weakness or paralysis on the left side of the body; problems with his or her vision; or hemispatial neglect (diminished ability to notice one side of the body) . A stroke affecting the left side of the brain could cause weakness or paralysis on the right side of the body; and difficulty with speech.

These effects might disappear or become less pronounced after a few months, or they may linger—it depends on how severely the brain was affected as well as the kind of rehabilitation and care a survivor receives.

Other common effects from a stroke include:

  • Dizziness or a sense of being off balance
  • Behavioral changes (such as a loss of inhibition, anger, or irrational jealousy)
  • Difficulty walking, often caused by foot drop (weakness in the muscles involved in lifting the front part of the foot)
  • Trouble swallowing or urinating
  • Muscle atrophy or spasticity (long periods of muscle cramping or spasms)
  • Fatigue or trouble sleeping

Long-term complications

It’s normal for stroke survivors to experience depression, anxiety, or feelings of frustration as a result of the physical effects of a stroke. A psychologist or psychiatrist may be helpful if your loved one is struggling with their mental health after a stroke.

Depression is only one common complication that can come from stroke. Other complications include:

  • issues affecting memory, perception, or personality
  • swelling in the brain (brain edema)
  • pneumonia
  • seizures
  • deep venous thrombosis (formation of a clot in a deep vein, typically in the leg)
  • urinary tract infections

Additionally, someone who has had a stroke is likely to have associated health problems like heart disease or hypertension (high blood pressure). Though these issues may not have been caused by the stroke itself, they are serious health risks that typically come with their own complications and they should be monitored closely. It’s important to communicate and regularly follow up with the treating physician so they can spot any warning signs for these complications and ensure your loved one is treated promptly.

Reducing risk of a second stroke

Although the risk for a second stroke goes up significantly after a person has survived one, the good news is that up to 80 percent of strokes are preventable. Some risk factors such as age or gender aren’t in anyone’s control, but other risk factors can be eliminated by making some lifestyle adjustments. Following some of these simple measures will help reduce the risk of another stroke:

  • Monitor blood pressure
  • Keep blood sugar low to prevent diabetes (which quadruples stroke risk) and avoid damage to blood vessels that could cause clots
  • Watch cholesterol levels
  • Stay active
  • Eat healthy
  • Ask a physician about heart medication

Stroke rehabilitation

While some lost function may return on its own as the brain heals, most stroke survivors will require some form of rehabilitation to help rebuild their strength, abilities, and confidence. It’s best for stroke survivors to begin rehabilitation as soon as possible after their stroke to give them the best possibility for regaining lost function. Some survivors recover quickly, while others may require rehabilitation for months or years after their stroke.

The kind of rehabilitation a stroke survivor will need depends on what abilities have been affected by their stroke. Rehabilitation typically involves both relearning certain skills (such as speaking) and learning new ways to complete tasks (like learning to write with a non-dominant hand). Health professionals will work with your loved one in rehabilitation sessions, but they may be expected to do exercises on their own or with a caregiver. For example:

  • If your loved one has trouble standing or walking, a physical therapist might assign them exercises to help strengthen muscles.
  • A speech pathologist can share techniques to improve communication and help with difficulty swallowing for those with dysphagia
  • For skills that need to be relearned, occupational therapists might help survivors practice new ways to do old tasks (for example, dressing using only one hand) that they will be expected to use in their day-to-day life.

It’s a good idea to plan regular check-ins with your primary physician and rehabilitation specialists. Your doctor will be able to monitor any potential health concerns, and the specialists can ensure your loved one is maintaining the skills they’ve developed during rehabilitation. It’s the job of these doctors and professionals to ensure you and your loved one are adjusting to the new demands of stroke recovery, and you should feel confident coming to them with any questions or concerns.

How much a stroke survivor will recover and how long the recovery process takes depends on many factors. Some survivors regain all or nearly all of their pre-stroke functions in a short time, while others will have some disabilities for the rest of their lives. Recovery is an ongoing process with the goal of survivors being able to live their life in spite of any effects of their stroke.

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