The Days and Months after a Stroke
Problems that come after a stroke
There are many problems that may happen after a stroke. Most are common and will improve with time and rehabilitation.
Many physical conditions are common after a stroke happens. They include:
- weakness, paralysis, and problems with balance or coordination
- pain, numbness, or burning and tingling sensations
- fatigue, which may continue after the patient returns home
- inattention to one side of the body, also known as neglect; in extreme cases, the stroke survivor may not be aware of his or her arm or leg.
- urinary or bowel incontinence
- speech problems or difficulty understanding speech, reading, or writing
- difficulty swallowing
- memory problems, poor attention span, or difficulty solving problems
- visual problems
- depression, anxiety, or mood swings with emotional outbursts
- difficulty recognizing limitations caused by the stroke
Common problems when a stroke happens on the right side of the brain:
- left-side weakness
- impulsive behavior
- overconfidence in abilities
- vision problems
Common problems when a stroke happens on the left side of the brain:
- right-side weakness
- speech and language problems
- slow behavior
Special Problems
Patients may need focused treatment to address certain other conditions.
Shoulder/hand syndrome: Shoulder/hand syndrome happens when the loss of a muscle group causes the shoulder to detach from its socket. The secondary disability may include tingling, varying feelings of hot and cold, and changes in sensation. Preventing the syndrome and treating it is critical in the rehabilitation process. It can be addressed with range of motion exercises.
Learned non-use: A phenomenon often seen in patients after having a stroke is “learned non-use.” The patient accepts the loss of function of a particular muscle or muscle group and only uses their “good side.” Treatment for this condition consists of advanced therapy that allows the brain to “re-wire” connections to help regain function and movement.
Spasticity: Spasticity is a frequent outcome of stroke. The patient’s limbs may change position; the neck, arms, or legs can get stiff, painful, or shorten, limiting mobility and interfering with activities of daily living. With specialized and individualized treatment at the IRR, quality of life can be improved. In addition to traditional medications, we offer treatments for spasticity including:
- phenol: A type of alcohol proven to prevent the transmission of excess nerve impulses when used in small amounts. It can allow for excellent spasticity control, especially in the elbow and thigh muscles.
- baclofen: This medication can be very effective in severe cases of spasticity. It is most effective when given through a surgically implanted pump, which allows for very low doses and minimal side effects.
- botulinum type A and type B (BOTOX): This can be very successful when used in small amounts for treating spastic muscles.
Communication Problems after a Stroke
Communications problems after a stroke may involve speech disorders, language disorders, cognitive-linguistic deficits, or a combination of all three. The speech-language pathologist evaluates and provides treatment for these problems.
Speech disorders:
- dysarthia: A collective term used to describe speech changes. Dysarthia may have any of the following causes: muscle weakness, incoordination, increased muscle tone, presence of involuntary movements, muscle stiffness.
- apraxia of speech: A specific type of neurologically-based speech change. It happens because of the brain’s inability to provide normal sensory and motor control of the jaw, lips, tongue, soft palate, or vocal cords.
Language disorders:
- aphasia: A disorder of language processing that happens because of damage to the brain. Aphasia affects a person’s abilities to understand spoken and written words and sentences, recall words, and formulate sentences. It does not affect someone’s level of intelligence, or their ability to hear and think. Aphasia can be like trying to learn – and use – a foreign language when living in a foreign country. It can be very frustrating both to the patient and their caregivers.
Cognitive-Linguistic Deficits:
- Deficits may include attention, memory, affect, social skills, thinking, and visual processing abilities.
Depression and Emotional Changes after Stroke
Depression is a frequent problem after a stroke. Physical and psychological symptoms can include:
- sudden mood changes
- feeling anxious or worried, pessimistic or hopeless
- having thoughts of death
- loss of energy
- increase or decrease in appetite
- difficulty sleeping or sleeping too much
- difficulty concentrating, remembering, thinking, or making decisions
- physical symptoms like headaches or digestive problems
- sexual problems
Talk with the patient’s doctor if there are concerns about depression. Antidepressant medication may be available, or it may be better to get a referral for a psychologist or psychiatrist. Increasing the amount of socialization with other patients may also help improve mood.