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Frequently asked questions about stroke
We are grateful to the Royal College
of Physicians for their kind permission to reproduce part of
their booklet "Care after Stroke. Information for patients
and carers". Published in 2004.
What is a stroke?
A stroke is a type of brain injury. Every stroke is different and people who have strokes are affected in different ways, ranging in severity from getting better within 24 hours, known as transient ischaemic attack (or TIA), to a stroke which may cause severe damage. Symptoms depend on the part of the brain that is affected. There are two main types of stroke:
- The most common type ('ischaemic' stroke) happens when blood vessels are blocked by a clot or become too narrow for blood to get through to the brain. The reduced blood flow causes brain cells in the area to die from lack of oxygen.
- In a 'haemorrhagic' stroke, the blood vessel is not blocked but it bursts and blood leaks into the brain causing damage.
When a stroke happens, some brain cells are damaged and others die. Brain cells which die cannot start working again. However, those just outside the area of the dead cells may recover as the swelling caused by the stroke goes down. Recovery can also occur as other parts of the brain take over from areas that died.
Stroke affects people in different ways. Some people experience a few mild effects which improve in a short time (sometimes only minutes or hours). Others suffer many severe effects which last for months or even years. The effects of your stroke will depend on the part of your brain that has been injured or damaged, how bad the injury is and your general health at the time of your stroke. Recovery can continue to occur for several years after the stroke.
Taken from pages 3-4 of the Care after Stroke booklet.
How can rehabilitation help?
Rehabilitation following your stroke should begin immediately. You will need care from specialist stroke services to provide rehabilitation designed to help you:
- regain abilities lost through stroke, for example helping you to walk, talk or use your arm again
- find new ways of coping with disabilities that are slow to recover, such as learning to write with the opposite hand
- cope with problems with daily activities including personal activities (eg dressing), domestic activities (eg cooking), community activities (eg shopping), hobbies and employment
- social, emotional and practical support following discharge from hospital.
Further rehabilitation may involve:
- staying in the hospital you were first admitted to
- transfer to another hospital or unit which specialises in rehabilitation
- discharge home with specialist stroke rehabilitation provided for you at home at a hospital out patients department or at a day hospital.
The kind of rehabilitation you have will depend on your needs, which should be assessed to see which treatments and therapies are needed to bring about as good recovery as possible. You may not need rehabilitation if your stroke was mild or you recover fully in a short space of time. Recovery tends to be most rapid in the first few weeks after stroke although rehabilitation can continue for many months. When rehabilitation no longer produces any marked Improvement it will usually be stopped but you should be reassessed regularly to see if a further course of rehabilitation would help. Just because therapy has stopped does not mean that you cannot continue to work on your own recovery, which may continue for many years.
Taken from page 11 of the Care after Stroke booklet.
What can be done to get back to a normal life?
It is common after a stroke for some people to have difficulty with common everyday activities such as dressing, cooking, shopping, hobbies and employment. You should be assessed by an Occupational Therapist for these problems to determine what sort of therapy will best help you. This may involve:
- advice on strategies to avoid doing things that are unsafe (eg getting into too hot a bathcutting yourself shaving),
- practising some of the activities with help and guidance from the therapist and nursing staff (eg dressing and cooking)
- special equipment to make activities like feeding or bathing easier for you
- arranging for adaptations to be made to your home to make it easier for you to carry on as normal a life as possible. This may require the Occupational Therapist to visit your home to see what is required, so that arrangements can be made for any work to be carried out by your local Social Services Department before you go home.
What can be done to help prevent a further stroke or TIA?
Once someone has had a stroke they are more likely to have another one. There are a number of precautions which can be taken to reduce your risk of having another stroke. These may include:
- following advice on lifestyle (including advice on your diet, achieving a satisfactory weight, regular exercise, stopping smoking and reducing alcohol and salt intake)
- making sure your blood pressure is controlled within safe limits
- drug treatments to reduce the risk of blood clotting. Sometimes this is as simple as taking an aspirin a day but may include other medication if you are allergic to aspirin, or prone to bleed esily, or your doctor thinks you would benefit from additional treatment, or if you have an irregular heart rhythm
- taking a tablet to reduce the cholesterol in your blood
- making sure your blood pressure is controlled within safe limits.
- drug treatments to ensure the blood flows more easily to the brain. Sometimes this is as simple as taking half an aspirin a day, but may include other medication if you are allergic to aspirin, or prone to bleed easily, or your doctor thinks you would benefit from additional treatment, or you have an uneven heart rhythm
- following advice on lifestyle (including advice on your diet, achieving a satisfactory weight, regular exercise, stopping smoking, reducing alcohol and salt intake).
To prevent another stroke occurring it is very important to continue with any of these measures for the rest of your life; if there are complications associated with any of them you should take professional advice, as there may be alternative ways of dealing with the problem.
Taken from page 17 of the Care after Stroke booklet
