Stroke
Two of the mostcommon psychological problems that can affect people after a stroke are:
Feelings of anger, frustration and bewilderment are also common.
You will receive a psychological assessment from a member of your healthcare team soon after your stroke to check if you are experiencing any emotional problems.
Advice should be given to help deal with the psychological impact of stroke. This includes the impact on relationships with other family members and any sexual relationship. There should also be a regular review of any problems of depression and anxiety, and psychological and emotional symptoms generally.
These problems may settle down over time but if they are severe or last a long time, GPs can refer people for expert healthcare from a psychiatrist or clinical psychologist.
For some people, medicines and psychological therapies, such as counselling or cognitive behavioural therapy (CBT) can help. CBT is a therapy that aims to change the way you think about things to produce a more positive state of mind.
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"Cognitive" is a term used by scientists torefer tothe many processes and functions our brain uses to process information.
One or more cognitive functions can be disrupted by a stroke, including:
As part of your treatment, each one of your cognitive functions will be assessed, and a treatment and rehabilitation plan will be created.
You can be taught a wide range of techniques that can help you re-learn disrupted cognitive functions, such as recovering communication skills through speech therapy (see below).
There are also many methods to compensate for any loss of cognitive function, such as using memory aids, diaries and routines to help plan daily tasks.
Most cognitive functions will return after time and rehabilitation, but you may find they do not return to their former levels.
The damage that a stroke causes to your brain also increases the risk of developing vascular dementia . The dementia may happen immediately after a stroke or may develop some time after the stroke occurred.
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Strokes can cause weakness or paralysis in one side of the body and can result in problems with co-ordination and balance.
Many people also experienceextreme tiredness (fatigue) in the first few weeks after a stroke, andmay also have difficulty sleeping, making them even more tired.
As part of your rehabilitation you should be seen by a physiotherapist, who will assess the extent of any physical disability before drawing up a treatment plan.
Physiotherapy will often involve several sessions a week, focusing on areas such as exercises to improve your muscle strength and overcome any walking difficulties.
The physiotherapist will work with you by setting goals. At first, these may be simple goals such as picking up an object. As your condition improves, more demanding long-term goals, such as standing or walking, will be set.
A careworker orcarer, such as a member of your family, will be encouraged to become involved in your physiotherapy. The physiotherapist can teach you both simple exercisesyou can carry out at home.
If you have problems with movement, you may also receive help from an occupational therapist, who can assess your ability to carry out everyday tasks and find ways to manage any difficulties.
Occupational therapy may involve adapting your home or using equipment to make everyday activities easier, and finding alternative ways of carrying out tasks you have problems with.
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After having a stroke, many people experience problems with speaking and understanding, as well as reading and writing.
This is called aphasia , or dysphasia,when it is caused by injury to the parts of the brain responsible for language. If the problems are caused by musclesinvolved in speech being affected, this is known as dysarthria .
You should see a speech and language therapist as soon as possible for an assessment, and to start therapy to help you withcommunication skills.
This may involve exercises to improve your control over your speech muscles, as well as using communication aids (such as letter charts and electronic aids) and alternative methods of communication (such as gestures or writing).
You can also read our guide on caring and communication difficulties .
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The damage caused by a stroke can interrupt your normal swallowing reflex, making it possible for small particles of food to enter your respiratory tract (windpipe).
Problems with swallowing are known as dysphagia . Dysphagia can lead to damage to your lungs, which can trigger a lung infection ( pneumonia ).
To prevent any complications from dysphagia, you may need to be fed using a feeding tube during the initial phases of your recovery. The tube is usually put into your nose and then passed into your stomach (nasogastric tube), but it may be directly connected to your stomach with a minor surgical procedure carried out using local anaesthetic (a percutaneous endoscopic gastrostomy, or PEG, tube).
In the long term, you will usually see a speech and language therapist several times a week for treatment to manage your swallowing problems. This may involve tips to make swallowing easier (such as taking smaller bites of food and advice on posture) and exercises to improve control of the muscles involved in swallowing.
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Stroke can sometimes damage the parts of the brain that receive, process and interpret information sent by the eyes. This can result in losing half of the field of vision for example only being able to see the left or right hand side of what is in front of you.
Strokes can also affect the control of the movement of the eye muscles. This can cause double vision.
If you have any problems with your vision after a stroke, you will be referred to an eye specialist called an orthoptist who can assess your vision and suggest possible treatments.
For example, if you have lost part of your field of vision, you may be offered eye movement therapy. This involves exercises to help you look to the side with the reduced vision.
You may also be given advice about particular ways to perform tasks that can be difficult if your vision is reduced on one side, such as getting dressed.
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Some strokes damage the part of the brain that controls bladder and bowel movements. This can result in urinary incontinence and difficulty with bowel control.
Some people who have had a stroke may regain bladder and bowel control quite quickly, but if you still have problems after leaving hospital, help is available from the hospital, your GP and specialist continence advisors.
Dont be embarrassed seek advice if you have a problem, as there are lots of treatments that can help. These include bladder retraining exercises, medications, pelvic floor exercises and the use of incontinence products .
There's no guarantee you won't have another stroke, but there's no reason why it should happen while you are having sex.
Even if you have been left with a severe disability, you can experiment with different positions and find new ways of being intimate with your partner.
Be aware that some medications can reduce your sex drive (libido), so make sure your doctor knows if you have a problem, as there may be other medicines that can help.
Some men may experience erectile dysfunction after having a stroke. Speak to your GP or rehabilitation team if this is the case, as there are a number of treatments available that can help.
Whether you can return to driving depends on what long-term disabilities you may have and the type of vehicle you drive.
It is often not the physical problems that can make driving dangerous (such as pressing the pedals or holding the steering wheel) but the problems with concentration, reaction time and awareness that can develop after a stroke.
Your GP can advise about whether you can start driving again a month after your stroke or whether you need further assessment at a mobility centre.
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If you have had a stroke, your chances of having another one are significantly increased.
Some studies have shown that, without treatment, you have around a 25% chance of having another stroke within five years and a 40% chance of having one within 10 years.
Therefore, you will usually require long-term treatment with medications aimed at improving the underlying risk factors for your stroke.
For example, you may need long-term treatment with medication to help lower your blood pressure, with anticoagulants or antiplatelets to reduce your risk of blood clots , or with statins to lower your cholesterol levels.
You will also be encouraged to make lifestyle changes to improve your general health and lower your stroke risk, such as eating a healthy diet, exercising regularly, stopping smoking if you smoke and cutting down on the amount of alcohol you drink.
These include:
Caring for somebody after a stroke can be a frustrating and lonely experience. The advice outlined below may help.
Someone who has had a stroke can often seem as though they have had a change in personality and appear to act irrationally at times. This is due to the psychological and cognitive impact of a stroke. They may become angry or resentful towards you. Upsetting as it may be, try not to take it personally.
It is important to remember that a person will often start to return to their old self as their rehabilitation and recovery progresses.
Rehabilitation can be a slow and frustrating process, and there will be periods of time when it appears little progress has been made.
Encouraging and praising any progress, no matter how small it may appear, can help motivate someone who has had a stroke to achieve their long-term goals.
If you are caring for someone who has had a stroke, it is important not to neglect your own physical and psychological wellbeing. Socialising with friends or pursuing leisure interests will help you cope better with the situation.
There are a wide range of support services and resources available for people recovering from strokes, and their families and carers. This ranges from equipment that can help with mobility, to psychological support for carers and families.
The hospital staff involved with the rehabilitation process can provide advice and relevant contact information.
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Strokes occur suddenly and all at once; they pose a very serious threat to a patient’s life. This condition requires immediate medical attention.
A stroke is a very severe condition. Immediate medical attention is necessary; the medical staff usually conducts a series of examinations and medical procedures to offer first aid.
Due to another disease or condition, a blood vessel in a certain area of the brain may rupture (break) and cause the blood to spread to the surrounding tissue and damage it.
At the onset of a stroke, a few main symptoms should be notices, which are easy to remember by using the acronym F.A.S.T. (Face, Arms, Speech, Time).
A myocardial infarction (MI), commonly known as a heart attack, occurs when a portion of the heart is deprived of oxygen due to blockage of a coronary artery. A stroke is a medical condition medical condition that occurs when the blood supply to part of the brain is cut off.
A person’s emotional state is an important factor in the function and development of their daily activities. Anxiety, depression and stress are conditions which compromise and affect a person’s daily life.
Risk factors for stroke, that are worth mentioning include: Atherosclerosis (Depositing of lipids in the lumen of blood vessels in the form of plaques), High blood pressure, Lack of physical activity, Obesity, Continuous consumption of alcohol, Smoking, etc.
It could occur that prior to a patient experiencing a stroke, they may experience warning signs. A few days or weeks in advance they may experience light symptoms such as unusual headaches, a light lip distortion, numbness in the arm or leg, vertigo, brief loss of vision, difficulties articulating, amnesia, etc.
There are different types of Stroke, they include: brain stroke of the ischemic type, brain stroke due to hemorrhage (cerebral hemorrhage) and hemorrhages due to the rupture of blood vessels or due to vascular malformation, etc.
A stroke due to a hemorrhage occurs more rarely than a cerebral ischemia. The major cause for this type of stroke is arterial hypertension.
The causes of Transitory Ischemia include: a blood clot, the narrowing of blood vessels in the brain, diabetes, high cholesterol levels.
Hypertensive encephalopathy is an acute syndrome during which severe hypertension is accompanied by headaches, nausea and vomiting, confusion, convulsions, stupor (somnolence) and coma, and other transitory neurological symptoms.
Shortly after the patient arrives at the hospital, physicians look for the typical symptoms of a stroke. These symptoms involve; Symptoms evident in the face, its retraction to one side (the face seems to droop on one side), problems with the limbs, (usually arms), hands and legs are numb or cannot be moved, etc.
A Stroke can be Ischemic or Hemorrhagic. Since these two types of stroke develop via different mechanisms, the treatment is accordingly different. Important for the treatment of strokes is preventing the disease a long time in advance.
A stroke is a serious and life-threatening medical condition that occurs when the blood supply to part of the brain is cut off. Strokes are a medical emergency and urgent treatment is essential because the sooner a person receives treatment for a stroke, the less damage is likely to happen.
A stroke is a severe condition and a serious threat, which requires immediate medical intervention. This disease is a major cause for invalidity and mortality in the world. Strokes are ranked third in the world in regards to mortality.
If you suspect that you or someone else is having a stroke, phone 999 immediately and ask for an ambulance. Even if the symptoms of a stroke disappear while you are waiting for the ambulance to arrive, you or the person having the stroke should still go to hospital for an assessment.
There are two main types of stroke - ischaemic strokes and haemorrhagic strokes - which affect the brain in different ways and can have different causes. Ischaemic strokes are the most common type of stroke.
Strokes are usually diagnosed by carrying out physical tests and studying images of the brain produced during a scan. Even if the physical symptoms of a stroke are obvious, brainscans should also be carried out to determine: if the stroke has been caused by a blocked artery (ischaemic stroke) or burst blood vessel (haemorrhagic stroke), which part of the brain has been affected, how severe the stroke is.
Effective treatment of stroke can prevent long-term disability and save lives. If your blood pressure is too high, you may be offered medicines to lower it. Medicines that are commonly used include: thiazide diuretics, angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers, beta-blockers, alpha-blockers. Some ischaemic strokes are caused by narrowing of an artery in the neck called the carotid artery, which carries blood to the brain. The narrowing, known as carotid stenosis, is caused by a build-up of fatty plaques.
Two of the mostcommon psychological problems that can affect people after a stroke are: Depression many people experience intense bouts of crying and feel hopeless and withdrawn from social activities, anxiety where people experience general feelings of fear and anxiety, sometimes punctuated by intense, uncontrolled feelings of anxiety (anxiety attacks). The injury to the brain caused by a stroke can lead to widespread and long-lasting problems.
The best way to prevent a stroke is to eat a healthy diet, exercise regularly, and avoid smoking and excessive consumption of alcohol. Ensuring a balance in your diet is important. If you have not fully recovered from your stroke, you may find that you will have become particularly sensitive to alcohol and even the recommended safe limits as above for the general population may be too much for you.
Jim Whyte was forced to give up work after having a stroke, but he's proved that there is life after a stroke. Jim had high blood pressure and was diabetic, which are both risk factors for stroke. However, he had never smoked and, due to his diabetes, was already following the healthy diet recommended for stroke survivors.
Having a stroke on the first day of his summer holiday was the last thing Stephen Harnet expected, especially as he was a healthy 32-year-old at the time. It turned out that the stroke was due to a condition I was born with called AVM (arteriovenous malformation), which is a tangle of abnormal blood vessels (arteries and veins), and can affect the brain and lead to a stroke. Before the stroke I was a technical manager working 12-hour days, seven days a week.
David Diston had a major stroke that left him paralysed down his right side and unable to speak. Now he has made a near total recovery, and has even run a marathon. He woke up in an assessment ward at Swindons Princess Margaret Hospital. He had no feeling or movement down his right side, and he couldn't speak. After a few days, he was moved to a specialist stroke unit where the doctors explained that he would have to learn to speak, write and walk again from scratch.
Manjit Bains was just 26 when he had a stroke. Determination, support from his family and friends and rehabilitation helped him get his life. "This hasn't been a solo journey. I've had a lot of support, including psychologists and counselling. After intensive care I was nursed on a medical ward at the hospital where I had been working."
Before June/ 17/ 2000, Jane Stokes CBE was a successful lawyer with a 25-year career in the civil service. She says her lifestyle may have raised her risk of a stroke. As a smoker, she had developed a two-pack-a-day habit. She drank moderately and neglected her fitness when her career began to take over. Recovery is a long process.