Editor's note: House Calls runs every other Thursday. Today's column is written by Beverly Sutter, physical therapy supervisor at Sutter Coast Hospital.
The term "stroke" is often used to describe a cerebrovascular accident (CVA) - a sudden, crippling, sometimes fatal occurrence.
Although young people, even children, occasionally suffer strokes, they most typically affect older people. When a stroke occurs, the blood flow through one or more blood vessels of the brain is disrupted. If the disruption is severe and prolonged enough to deprive brain tissue of blood and oxygen, the involved tissue will cease to function and die.
The warning signs of a CVA or stroke include dizziness; unsteadiness; sudden falls; temporary dimness or loss of vision, particularly in one eye; temporary loss of speech or trouble in speaking or understanding speech; or sudden weakness or numbness of the face, arm and leg on one side of the body.
Many major strokes are preceded by transient ischemic attacks (TIAs)
or "mini strokes." They may even be a cause of dementia.
Silent strokes are different frommini strokes, which are noticeable
but last only for minutes or hours. A silent stroke is generally found
incidentally during an MRI of the brain. When patients are asked if they
remember having a stroke, they are often surprised, having never
exhibited any symptoms. A recent study showed that by the age of 69,
approximately 10andndash;11 percent of people who consider themselves
"stroke-free" have suffered at least one that can be seen on MRI.
When researchers looked at MRI scans performed several years later
for signs of silent stroke - when the participants were an average age
of 70 - they found that the moderate-to-heavy exercisers were 40 percent
less likely to have suffered a silent stroke than the non-exercisers.
The risk factors for a stroke are hypertension, heart disease,
diabetes, cigarette smoking, physical inactivity, obesity, excessive
alcohol consumption and increased blood cholesterol and lipids. People
should take responsibility for their health and decrease risk factors.
Rehabilitation following a strike typically includes physical
therapy, occupational therapy and speech therapy. Rehabilitation
typically starts as soon as the patient is medically stable, usually
within 72 hours of onset. The location and size of the ischemic process,
the nature and functions of the structures involved, and the
availability of collateral blood flow all influence the symptoms seen
and the recovery rate. An effective rehabilitation program should seek
to prevent or lessen secondary impairment and provide a safe and
effective environment for the relearning of functional skills.
Physical therapy goals typically include improving range of motion,
strength and the ability to walk safely. Occupational therapy goals
typically include improving one's ability to do normal activities such
as dressing, grooming and eating. Speech therapy goals typically
include improving respiration, facial functions, swallowing and chewing.
The goal is to make survivors as independent and productive as
possible and to prevent additional strokes.
Email suggestions for future House Calls columns to Beth Liles at
Sutter Coast Hospital, firstname.lastname@example.org