Patient education: Recovery after stroke (The Basics)

What happens after a person has a stroke? — Strokes affect people in different ways. Some people who have a stroke lose important brain functions. For example, they might become partly paralyzed or unable to speak.

Here are some of the most common long-term problems that can be caused by a stroke:

●Speech problems – People who have a stroke sometimes can't speak anymore or can't understand speech. The medical term for this is "aphasia." Some people might still be able to speak but have slurred speech. The medical term for this is "dysarthria."

●Weakness and movement problems – People who have a stroke sometimes have muscle weakness or paralysis of the left or right side of the body. The muscle weakness can affect the face, arm, and leg. The medical term for this is "hemiparesis." People who have a stroke can also have trouble walking, grasping objects, or balancing. Plus, they might not be able to make controlled, planned movements, even if the stroke did not cause weakness or loss of sensation. The medical term for not being able to make planned, controlled movements is "apraxia."

●Partial loss of sensation – People who have a stroke sometimes have partial or total loss of feeling on the left or right half of their body.

●Trouble eating or swallowing – People who have a stroke sometimes have trouble swallowing. The medical term for this is "dysphagia." Sometimes, this problem causes food to go down the wrong way and into the lungs. This is dangerous because it can lead to lung infections, such as pneumonia. Some people need a feeding tube if they have this problem. Others can adapt by changing the foods and liquids that they eat and drink.

●Problems thinking clearly or interacting with others – People who have a stroke sometimes get confused easily or have trouble staying focused. They can also have behavior changes that make them act differently than they did before the stroke.

●Depression – People who have a stroke also sometimes get depressed. This can make recovery even harder. It's important to get treated for depression after a stroke.

●Problems with bladder control – People who have a stroke sometimes can't control their bladder or leak urine. The medical term for this is "urinary incontinence." It often gets better over time.

What happens during recovery from a stroke? — During recovery, people work to regain some of the abilities they lost. Even though a part of their brain was damaged by the stroke, their brain might be able re-learn how to do some or all of the things it used to do. But some people with big strokes do not recover much.

People who can't speak after a stroke can often re-learn how to speak or at least how to communicate a little bit. In the same way, people who can't walk can sometimes re-learn how to walk. (Some people will need to use canes or other devices to walk.)

What is stroke rehabilitation? — Recovery often involves treatment in a stroke "rehabilitation" facility. This is also called stroke "rehab." In rehab, there are many different medical professionals who specialize in helping people who have had a stroke. They can:

●Help you regain some of the abilities that you lost

●Give you tips on how to cope with the problems caused by the stroke

Here are a few examples of how rehab could help you:

●If you can no longer walk very well, a physical therapist (exercise expert) can show you ways to improve the way you walk. They can also recommend braces, canes, and other devices that might make it easier for you to walk.

●If you can no longer swallow well, a speech and language therapist can teach you to do exercises that might improve how you swallow. They can also offer tips on how to cope with swallowing problems. For instance, the therapist might suggest that you add powders or other ingredients to the liquids you drink, so that they are thick and less likely to go down the wrong way.

●If you can no longer hold your toothbrush to brush your teeth, an occupational therapist can show you new ways of holding your brush, so that you can use it.

●If you are depressed because you had a stroke, a psychiatrist (doctor who specializes in mental health) can prescribe medicines to treat depression. They can also talk to you about the way you feel about the stroke.

Where does stroke rehabilitation happen? — Stroke rehab can happen in different places. Your doctor will work with you to decide which place is best for you. This will depend on your overall health, what you need help with, and your preferences. You will also need to think about things like your insurance coverage and whether you have support at home.

You might have rehab at:

●An "inpatient" hospital or center – You might stay in the hospital or be moved to an "inpatient" rehab center. You might have therapy for several hours each day.

●A nursing facility – You will have therapy for a few hours each day.

●Your home – In certain cases, therapists can come to your home or wherever you are staying. This is not always an option.

●An "outpatient" rehab center – This involves going to the center a few times each week to work with a therapist. This is often done right away for mild strokes. Or a person might go to an outpatient center after leaving 1 of the other types of rehab.

What are the chances of recovery after a stroke? — The chances of making a good recovery depend on many things, such as:

●How big the stroke was

●What part of the brain was damaged by the stroke

●How old the person is (younger people tend to recover better than older people)

●What other medical problems the person has (such as heart failure or cancer)

●Whether the person was sick before the stroke happened

●How soon the person was treated following the stroke

In many cases, a person won't ever be exactly the same as before a stoke. But the brain can usually adapt and recover some function. The most important thing you can do is continue rehab and do all the exercises and therapies that your health care team recommends. Also, be patient. It takes time to heal and learn new ways to cope, but work and patience can pay off.

More on this topic

Patient education: Stroke (The Basics)
Patient education: Aphasia (The Basics)
Patient education: Dysarthria (The Basics)
Patient education: Lowering the risk of having a stroke (The Basics)
Patient education: Medicines after an ischemic stroke (The Basics)
Patient education: Hemorrhagic stroke (The Basics)
Patient education: Transient ischemic attack (The Basics)
Patient education: Carotid artery disease (The Basics)
Patient education: High blood pressure in adults (The Basics)

Patient education: Stroke symptoms and diagnosis (Beyond the Basics)
Patient education: Ischemic stroke treatment (Beyond the Basics)
Patient education: Hemorrhagic stroke treatment (Beyond the Basics)