Stroke

Updated 07 August 2015

Rehabilitation after a stroke

A stroke is the third most common cause of death in South Africa and occurs when a clot stops the blood flow to the brain or because an artery breaks or bursts.

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Sometimes there is only temporary damage to brain cells so they can continue functioning with therapy. Yet, in most cases, rehabilitation is started as soon as possible so that the patient can return to a normal life.

Read: Brain stimulation for stroke recovery

Treatment options

Most victims require immediate hospital treatment where they are given fluids to prevent dehydration and physiotherapy to prevent pneumonia. They require constant physical attention, including being repositioned in bed, and given skin care to prevent bedsores. In severe cases, emergency neurosurgery may be needed to remove blood clots or repair a ruptured aneurysm.

Ischemic stroke

Emergency treatment for an ischemic stroke depends on the location and cause of the clot. Intravenous (into the veins) fluids and medications such as clot dissolving drugs and anti-platelet drugs are administered.

The majority of strokes are caused by blood clots which shift to a blood vessel in the brain and block blood flow to that area. This type of stroke is known as an ischemic stroke and thrombolytics are most commonly the drugs used within three hours of the first stroke symptoms.

What is thrombolytic therapy?

Thrombolytic therapy refers to the use of drugs to break up blood clots, which are the chief cause of heart attacks and stroke. The most commonly used drug for thrombolytic therapy is tissue plasminogen activator (tPA) and research suggests your survival and recovering chances are greatly improved if you are given a thrombolytic drug within 12 hours.

They work by dissolving a major clot which restarts blood flow to the heart and helps prevent damage to the heart muscle.

Read:Music speeds stroke recovery

How thrombolytic treatment works

The most common way this treatment is performed is to inject clot-dissolving medications into a blood vessel where they then flow through the bloodstream to the clot, and dissolve it.
Another way is via a catheter which is inserted through the blood vessel to the area of the clot where it delivers the medications.
Not everyone is a candidate for thrombolytics, and deciding factors include:

•    Age
•    Gender
•    Medical history

You may be refused one of you have any of the following because of the increased risk of bleeding associated with these conditions.

•    Active bleeding or severe blood loss
•    Severe high blood pressure
•    A recent head injury
•    A stroke from bleeding on the brain (a haemorrhagic stroke)
•    Bleeding ulcers
•    Liver disease
•    Pregnancy
•    Recent surgery

Read: Being fit may aid stroke recovery

Haemorrhagic stroke


Surgery may be used to treat a haemorrhagic stroke or prevent recurrence. The most common procedures include aneurysm (weakened or ruptured blood vessel) clipping and the removal of arteriovenous malformation (AVM) - masses of abnormal blood vessels in the brain. Both surgeries carry high risks.

Recovery


Whether it’s for ischemic or a haemorrhagic stroke, rehabilitation is vital. Some have difficulties such as speech and movement affecting recovery and rehabilitation.

Read more:
Video games help stroke recovery
Experts update stroke prevention guidelines
Irregular heartbeat doubles risk of silent strokes

 

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