World Stroke Day: A stroke or a brain attack occurs when blood supply to a part of the brain is blocked, or when a blood vessel in the brain bursts, as a result of which parts of the brain become damaged or die. When a stroke occurs, there could be sudden bleeding in the brain. When stroke occurs because blood flow to the brain is blocked, it is called an ischemic stroke. Due to an ischemic stroke, the brain cannot get oxygen and nutrients from the blood. When the brain does not receive oxygen and nutrients, brain cells start dying within minutes.
When a stroke occurs because of sudden bleeding in the brain, it is called a haemorrhagic stroke. The pressure exerted by the leaked blood on the brain damages brain cells.
A little less than 90 per cent of strokes are ischemic strokes, while the rest are hemorrhagic strokes.
What are the physical and speech problems experienced by people after a stroke?
Even after a person has recovered from a stroke, some physical symptoms may arise. Speech and mental health problems may also occur.
According to the University of Pittsburgh Medical Center, common post-stroke physical problems include weakness, paralysis, and trouble with balance and coordination, fatigue, urinary or bowel incontinence, trouble swallowing, vision problems, trouble recognising limitations caused by a stroke, pain, numbness, burning and tingling feelings, neglect to one side of the body, lack of awareness of the arm or leg, speech problems or trouble understanding speech, reading, or writing, memory problems, poor attention span, difficulty solving problems, and depression, anxiety, or mood swings with emotional outbursts.
When a right-side stroke occurs, the left side of the body experiences problems such as muscle weakness or stiffness. There is impulsive behaviour, vision problems, and overconfidence in abilities. Paralysis on the left side of the body may occur, memory loss may happen, and the person starts exhibiting an inquisitive behavioural style.
When a left-side stroke occurs, movement on the right side of the body is affected. There are right-side weaknesses, slow behaviour, and speech and language problems.
“A stroke can result in paralysis or weakness of the muscles, which can impact the face, arm, or leg on the affected side. Strokes can cause balance and coordination issues, making it challenging to stand, walk, or use fine motor skills. Visual issues following a stroke might include double or blurry vision, as well as partial or total blindness,” Dr Vipul Gupta, Chief, Neurointerventional Surgery & Co-Chief, Stroke Unit, Artemis Hospital, Gurugram, told ABP Live.
When muscles decrease in size and strength, and the shoulder detaches from its socket, shoulder-hand syndrome, characterised by symptoms such as tingling, changes in sensation, and varying feelings of hot and cold may occur. There is also memory loss, cautious behaviour is seen, and speech and language problems occur, according to the American Stroke Association.
“Some people may experience altered sensations in the affected body areas, such as tingling, numbness, or discomfort,” said Dr Gupta.
After a stroke, people may experience a rare syndrome called “learned non-use”, a condition which happens when one accepts the loss of function of a muscle, and only uses the “good side”. By rewiring connections in the brain, the condition can be treated, and function and movement can be restored.
Another after-effect of stroke is spasticity, a condition in which the limbs may change position, and the neck, arms, and legs can become stiff, painful or shortened.
Some of the speech problems that may occur after a stroke include dysarthria, a condition characterised by muscle weakness, a lack of coordination, presence of involuntary movements, the loss of ability to execute speech in a skilled manner, and increased muscle tone (muscles become too stiff). Dysarthria is a type of neurology-based speech change that happens when the brain is not able to provide normal sensory and motor control to the jaw, tongue, vocal cords, lips, and soft palate.
Apraxia, or the inability to execute speech in a skilled manner when asked, is characterised by distorting sounds and words, putting wrong stress and tone on a word, struggling to say the right world, speaking more slowly, not being able to make sounds at all, saying one word when the person meant another, having trouble saying longer and complex words, being inconsistent in speech, and aphasia.
Aphasia is a neurological disorder that impacts language and speech, and other cognitive abilities.
Aphasia is a language disorder caused by damage in the area of the brain that controls language expression and comprehension, according to the University of Rochester Medical Center, New York.
Aphasia leaves a person unable to communicate effectively with others and is usually diagnosed based on which area of the language-dominant side of the brain is affected, and the extent of the damage.
Aphasia affects one’s ability to understand spoken and written words and sentences, form sentences, and recall words, but does not affect one’s level of intelligence, or thinking and hearing abilities.
“People who suffer from aphasia may find it difficult to understand, speak, read, or write,” said Dr Gupta.
Stroke survivors also suffer from cognitive disabilities such as a short attention span, loss of social skills, problems with visual processing and communication, memory loss, and thinking problems.
Depression, anxiety, loss of energy, headaches, and digestive problems may also occur.
In some cases, a stroke may occur in the brain stem. Depending on the severity of the injury, a stroke occurring in the brain stem can affect both sides of the body, and leave the person in a ‘locked-in’ state. This means that the person is unable to speak or achieve any movement below the neck.
According to Dr Gaurish Kenkre, General Manager and Center Head, Atharv Ability, a Mumbai-based neuro rehabilitation centre, stroke can have various physical effects beyond paralysis and aphasia. “These include difficulty with gripping or holding things, fatigue or tiredness, incontinence, pain, restricted mobility, swallowing difficulties, vision problems, and weakness.”
A stroke survivor may find it difficult to hold or grip on to things due to the loss of fine motor skills, fatigue or tiredness occur because of physical changes, mood swings, and difficulty sleeping, incontinence happens because of medication, muscle weakness, or sensory changes, and pain occurs due to actual damage to tissues, causing nociceptive pain, or due to damage to nerves that send incorrect messages to the brain, resulting in neuropathic pain. Due to weakness, there is restricted mobility, and visual impairment affects daily activities.
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