Stroke Induced Brain Injury

A stroke is a serious, potentially life-threatening medical event that may cause long term brain injury and physical disability. In the U.S., about 600,000 strokes are reported each year and stroke is the third leading cause of death. However, knowing a stroke’s warning signs and receiving immediate treatment can lessen the impact of stroke-induced brain injury and there are numerous measures you can take that may prevent strokes from happening or recurring.

A stroke occurs when the blood supply to part of the brain is suddenly blocked or cut off (called an ischemic stroke) or when blood vessels in the brain suddenly burst (called a hemorrhagic stroke). These traumatic events interrupt the flow of oxygen to the brain and cause brain cells to die off rapidly. When this happens, the patient may show symptoms of sudden confusion, trouble speaking or understanding speech, dizziness, trouble walking or loss of balance, sudden numbness or weakness, especially on one side of the body, trouble seeing in one or both eyes, or sudden severe headache. The onset of these symptoms is usually very rapid and the person experiencing a stroke may not realize what is happening but simply appear dazed or confused.

Recognizing the symptoms of a stroke and receiving immediate treatment at a hospital, preferably within 60 minutes of a stroke, can be important factors in reducing stroke-induced brain injury. The longer the flow of blood is interrupted in the brain, the greater the potential for long-term brain injury. In one study, patients who received hospital treatment within three hours of a stroke were 30 percent more likely to recover with less permanent disability. If you or someone you know appears to be suffering a stroke, every minute counts and getting immediate medical assistance will help minimize the extent of stroke-induced brain injury.

Once the patient is hospitalized, new drugs and medical treatments are used to control hemorrhaging and break up blood clots in the brain before extensive brain damage takes place, however stroke-induced brain injury cannot be reversed. Even after the patient has been stabilized physically, there are often lasting physical and mental impairments. The types of disability caused by a stroke depends on which areas of the brain have been injured and may include: 1) problems with motor control, including paralysis or weakness on one side of the body, swallowing, walking, posture, or balance, and loss of continence; 2) unusual physical sensations such as pain, numbness, or tingling, or the inability to feel touch, pain, or temperature; 3) difficulties with speech and language; 4) problems with thinking, planning, memory, and judgment; and 5) emotional distress such as feelings of sadness, grief, anxiety, and depression.

These new difficulties can be physically and emotionally overwhelming to the patient and his or her family, and most stroke patients will need to undergo some form of rehabilitation to learn to cope with their effects.

Rehabilitation should begin as soon as the patient is stabilized, usually within 24 to 48 hours of being hospitalized, and is focused on restoring the patient's physical well-being and mental skills that have been lost due to stroke-induced brain injury. The first stages of rehabilitation may include simply helping the patient regain the ability to move his or her limbs, sit up, walk, and use the toilet while remaining hospitalized.

Longer term goals, however, may require that the patient learn new ways to dress, bathe, eat, walk, carry household objects, or communicate to compensate for the deficits caused by the stroke, such as the loss of the use of an arm, difficulty moving, or problems with language and memory. Physical and speech therapists may assist the patient in relearning how to perform everyday tasks by designing personalized focused regimens that include repetitive motion exercises, strength and endurance programs, sensory stimulation, hydrotherapy, language coaching, and changes to the individual’s physical environment meant to restore the patient’s ability to resume a high level of normal activity and independence.

In addition, studies suggest that due to the brain’s own ability to regenerate, known as plasticity, the brain itself may be able to overcome some of the effects of stroke-induced brain injury by forming new neural connections that help the patient accomplish these tasks. These activities may take place in a hospital or rehabilitation facility, or in the patient's home, with the help of rehabilitation specialists and supportive family members. The patient’s doctors will also monitor the patient’s physical well-being and seek ways to prevent an occurrence of further strokes.

Stroke-induced brain injury results in permanent damage, so the best treatment to prevent the occurrence or the reoccurrence of stroke is to reduce the risk factors that cause stroke, including high blood pressure, heart disease, diabetes, high cholesterol, and smoking. If you suffer from any of these conditions, talk to your doctor about ways that medication, diet, exercise, and stress reduction techniques can help reduce or eliminate your risk. You can learn more about how you can reduce your risk of stroke by talking with your doctor or by visiting the websites of the National Institutes of Health/National Institute of Neurological Disorders and Strokes (NINDS), the American Medical Association, or other professional organizations.