Did you know that strokes are the 3rd most common cause of death and the second most common cause of neurological disorder among adults (Merck Manual, 17th edition)? According to Health Canada, between 40,000 and 50,000 Canadians are hospitalized each year for stokes, and about 15,000 of these are fatal. In 2003, about 272,000 Canadians 12 years of age and older were living with the effects of having a stroke (Health Canada stats). As people age, the risk of having a stoke increases, and after the age of 55 the risk doubles every 10 years – which is why educating yourself about the risks, causes and warning signs are critical. My story comes from a personal experience of a stroke, which helped to shape my foundation of understanding this debilitating condition. In 1995 my dad had a stoke, which originally left him completely paralyzed on the left side of his body, this is called Hemiplegia and is a common effect following a stroke. He is still unable to function in many ways as he did prior to the stroke; his whole life was completely changed.
A stroke is also known as cerebrovascular disease, resulting from an injury or interruption in the blood vessels supplying the brain. Strokes generally occur due to 2 major causes: Ischemic stokes (80%); which means they happen due to an interruption of blood flow to the brain due to narrowing of the arteries, or a blood clot. The clot is basically formed from a build up of plaque in the arteries (fats, calcification, scar tissue), which acts to narrow the arterial pathway or creates a clot in the blood, which travels towards the brain and blocks the blood flow. Prognosis for recovery is generally better with an ischemic stroke, as compared to the other major type; hemorrhagic (20% of cases). Hemorrhagic strokes are caused from uncontrolled bleeding to the brain, which will in turn cause brain cell death. The two types of hemorrhagic stroke are uncontrolled bleeding on the surface of the brain (subarachnoid), or the rupture of an artery deep within the brain (intracerebral). The individual, who suffers a stroke of either type, will present with symptoms based on the area and amount of the brain affected and the extent of damage to the brain cells, which is why the symptoms an individual will present with vary to such a degree from person to person.
The brains motor functioning affects the opposite side of the body, as in the case of my father, his right side of the brain was damaged which caused alterations to the left side of his body. The paralysis he suffered was luckily temporary, following the initial stroke; he regained partial movement and sensation within 1 month. It took 3 months for him to be able to walk again, after extensive rehabilitation. It was a very difficult process to have to relearn these basic skills again as an adult, such as walking, and holding a pencil or a glass in his left hand. Today, he has a permanent contracture (muscle shortening) in his left hand and arm, limited movement and strength in his left shoulder, both of which leave him with altered function in this limb. He also has a limp and weakening of his left leg. As the day progresses, and his brain becomes tired, he stutters more, his mouth on the left side begins to droop, and his physical symptoms on the left side of his body become more pronounced. He has also become more emotional since the stroke, with an exaggerated response to sadness. He has been left with changes in his personality, has a difficult time learning new skills, is unable to be in places where there are crowds, he gets confused easily, and due to all these changes suffers from depression. It is sometimes difficult to know how to support these changes, even 12 years later. I have been fortunate to do some therapy with my father, helping through massage to offer supportive touch, to ease some of the contracture in the muscles, and to help to stimulate the opposing muscles, which have lost their muscle tone. I know it helps physically, even if only temporarily, and emotionally it helps him to accept his body as it is now – accept himself with all the changes the stroke has left him with. For treatment, my dad has to take a blood thinner called warfarin as well as a ¼ aspirin a day, for the rest of his life, to help prevent another reoccurrence of a second stroke as the elementary cause was due to an embolism (a clot which has traveled to the arteries of his brain).
I want to leave you with a list of warning signs of a stroke, adapted from the health Canada website. The quicker you can recognize these signs and get an individual help, the less severe and permanent the effects will be, as well as a decreased risk of death. A person would present with sudden weakness, numbness and/or tingling in the face, arm or leg. They will have a sudden temporary loss of speech or trouble understanding speech, sudden loss or alteration of vision, sudden severe or unusual headache, and/or they will have a sudden fall or unsteadiness. Know these signs and educate yourself, as a stroke may happen to you, or someone you love – which will impact your life forever.
For more information please go to the Health Canada and Heart and Stoke foundation websites. They have a wonderful resource center with helpful links, suggestions for minimizing your risks as well as identifying risks, and an abundance of information.
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