Stroke can have varying effects on different individuals, so there is no way to predict stroke severity until a proper examination by a specialized neurologist is conducted. Physicians measure the initial damage of a stroke by using the NIHSS (National Institute of Health Stroke Scale). This scale measures the level of brain damage in terms of physical and cognitive impairment. These functions are related to consciousness, vision, sensation, movement, speech, and language; they are measured when evaluating stroke severity to determine how much function was destroyed by the incident. The levels of stroke damage vary from no damage at all, minor stroke, moderate stroke, moderate to severe stroke, and severe stroke.
Stroke Side Effects
- A decrease in consciousness. The doctor will ask the patient simple questions about the date (month, day, and year), their name, their loved one’s names, and the ability to follow simple commands (like closing their eyes or making a fist). In addition, the patient may experience changes in personality, mood, and emotions.
- A decrease in vision control. Patients may not be able to move their eyes normally following a stroke. This refers to the ability to follow an object with their gaze. In addition, they may have a decrease in their visual field, which relates to the ability to notice things in their peripheral vision.
- A decrease in motor function and control. This refers to the ability to use the muscles in the arms and legs. Depending on the severity of the stroke, a patient may experience disability (or even paralysis) in some or even all of their limbs. The doctor will test a patient’s ability to hold their arm or leg out in front of them for 10 seconds. The key is making sure the patient doesn’t exhibit shakiness, unsteadiness, or drift. In addition, the doctor will text for limb ataxia, which results from motor damage in the cerebellum. They will ask the patient to touch their fingers to their nose and their heels to their shins on both sides to test for coordination. The doctor also checks for facial palsy, to check if a patient can adequately move their facial muscles.
- A decrease in sensory functioning. Some stroke patients experience a decreased sensory response to certain stimuli, whether it’s touch, sight, smell, taste, or hearing. The doctor will assess the patient’s response to a variety of sensory stimuli (like a pinprick or a hearing test). In addition, the doctor will test for extinction and inattention of senses. This refers to the amount of attention the patient gives to their five senses and their environment. There are several proven techniques to improve sensation after stroke.
- A decrease in language ability. Stroke patients are also known to suffer from linguistic deficits following a stroke. This refers to the ability to express oneself using words, as well as the ability to comprehend and understand words being directed towards you. The doctor will ask the patient to describe a situation taking place in a picture to test their language capabilities. In addition, they will test for dysarthria, which is the tendency of stroke patients to slur their words. The doctor will evaluate to what extent the patient is slurring their speech to determine the severity of their linguistic deficit.
On average, the lower the score of brain damage, the higher the likelihood that the patient will make a full recovery. The more brain damage a patient experiences, the more difficult it will be to recover to previous levels of cognition and function. Stroke recovery time will vary for each patient. While some fully recover after a few months with little to no symptoms, others may face a long, hard road to recovery with many life-long deficits. Below, we provide a general guideline of what kind of outcomes to expect week-to-week during the stroke rehabilitation process.
- Begin rehabilitation exercises immediately after a doctor’s evaluation. Often times, they will recommend specific exercises or physical therapies. In this stage, the brain has the highest levels of neuroplasticity, meaning the neural networks are rapidly forming new connections to make up for those damaged by the stroke. In order to take advantage of this hyperactive state, it is recommended that patients begin rehabilitative exercises even in the hospital bed.
- During this time, studies show that the patient regains about 50% of their original function. Depending on how severe the stroke was, the patient may be discharged from the hospital as early as in the second week. However, it is very important to continue regular, intensive physical therapy to increase mobility.
- Fast-forwarding to the third month, patients can expect to experience a slight plateau in recovery. While results may appear to slow down, it is important to keep up with the recovery regimen. Switching up the exercises or adding in new ones can aid in recovery.
- Keep on working towards recovery! This month is characterized by ongoing physical therapy. Doctors recommend that you practice the skills you learn at home and between outpatient sessions. Repetition is key in retaining skills!
- Fast-forwarding to the sixth month of recovery, patients can expect to see a significant improvement in gait (manner of walking). Whether you are able to walk, stand, both, or require a cane/walker, this is considered progress. Continue to push and motivate yourself using enjoyable activities, family members, and a support system.
- It’s been a year since your stroke and look what you’ve accomplished! While patients may not be fully recovered, there is a significant improvement in cognition, motor functions, and daily tasks. This may allow the patient to perform certain activities on their own, regain some control in their lives, and regain their sense of self and lifestyle. Each patient will move through the stages of recovery at different rates, and there is no one-size-fits-all approach to stroke. One of the most important things to remember is that there is always hope. A patient with a positive attitude is more likely to make a full recovery than a patient with a negative one. Outlook and perception are more important than people think!
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