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Types of stroke

Embolism is where an object, most commonly a blood clot, blocks an artery. These clots can occur in other parts of the body then break up and travel to the brain where they lodge in the brain’s smaller blood vessels.

Thrombosis is where there is a gradual closure of a blood vessel. In a stroke, it is most commonly fatty lipids called plaques building up on the walls of blood vessels and restricting blood flow. As a result, symptoms usually develop slowly but may be rapid in some cases.

Haemorrhage is severe bleeding. Two kinds can cause a stroke. An intracerebral haemorrhage is caused by a ruptured artery leaking blood directly into the brain. A subarachnoid haemorrhage occurs on the surface of the brain, and the blood fills the space around the brain and creates pressure.

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Effects of stroke

The effects of a stroke vary widely for each stroke patient depending on which part of the brain is affected. Different parts of the brain are responsible for thought processes, comprehension, movement and our senses. The extent of blood shortage also determines the effect of the stroke.

A stroke may generally result in:

  • Paralysis,
  • Loss of feeling
  • Communication difficulties
  • Visual problems
  • and many other issues depending on which part of the brain is affected:

Treatment

Surgery, drugs, acute hospital care and rehabilitation, are all accepted stroke treatments depending on the type of stroke.

An example of surgery is a carotid endarterectomy to remove plaque if a neck artery is blocked. Aspirin is a common drug used for thinning the blood. Other medications aim to dissolve clots that lead to stroke. New techniques continue to arise, such as cerebral angioplasty where balloons, stents and coils are used to dilate small intracranial arteries.

Recovery and rehabilitation

Generally speaking the brain does not regenerate if brain tissue dies after an embolism or thrombosis. After a haemorrhage the brain may regain some function after the pressure caused by bleeding has decreased.

Recovery after a stroke depends on many factors, including:

  • Type and severity of the stroke
  • Parts of the brain involved
  • Extent and nature of the damage
  • Existing medical problems
  • Type of treatment and rehabilitation.

Recovery usually involves a lot of relearning of activities such as walking and talking. Relearning can be complicated as many people have trouble concentrating after a stroke. Research funded by the Stroke Association of Queensland found that attention was affected markedly by a stroke in the front right side of the brain. This part of the brain is responsible for attention and concentration and a stroke here was found to lead to slower rehabilitation as learning was impaired.

Rehabilitation aims to:

  • Help you understand and adapt to your difficulties
  • Regain skills
  • Prevent secondary complications
  • Help you and your family to come to terms with the stroke.

Knowledge of rehabilitation following a stroke is growing steadily, as neurologists and neuropsychologists experiment with using mirrors or offset treadmills to retrain muscle groups and nerve pathways. As with any other form of brain injury, the key is understanding, persistence and a close relationship with the medical team.