The human brain is a wonder of evolution. It is capable of moving mountains and building cities, curing diseases, inventing new gadgets, and shaping society more than any other animal species. However, when the brain is denied oxygen, as is the case with a stroke, its capabilities can be altered for the worse. In a matter of seconds, the most powerful person can be physically paralyzed, and left with devastating consequences for life.
Each of the five different types of stroke is caused in some way, shape, or form by a blood clot or blood vessel malfunction. Blood clots cause brain cells to die from a lack of oxygen, which leads to limb paralysis and permanent neurological damage.
Here are the various types:
- Ischemic strokes occur when blood vessels leading to the brain are obstructed. They account for 87 percent of all strokes.
- Hemorrhagic strokes happen when a blood vessel ruptures, resulting either in a brain aneurysm or an arteriovenous malformation. Often, high blood pressure is the culprit in these types of strokes.
- Transient Ischemic Attack is a less severe stroke (often called a “mini-stroke) caused by a clot that can lead to a worse stroke later on.
- Cryptogenic strokes are caused by a larger blood clot that blocks the flow of blood to the brain.
- Brain stem strokes sometimes impact each side of the body and cause paralysis below the neck.
Some strokes are unpreventable, and their causes unknown. Even healthy adults can suffer from a stroke without warning.
If that’s not enough to instill fear in the average person, the statistics on strokes are even more sobering. The CDC reports that nearly 800,000 Americans suffer one each year, about 610,000 of which are first-time strokes. That makes for one new stroke every 40 seconds. Of those people affected, between 10 and 20 percent die due to complications. Strokes cost the US about $53 billion per year for time off work, medical treatment, and healthcare services. They are also the number one cause of disability on a long-term basis, reducing mobility in more than half of the remaining survivors over the age of 65. Roughly six million Americans live with disabilities caused by strokes.
How can we curb this common health issue that robs people of dignity and sometimes their very lives? Currently, treatment — whether by medical means or through rehabilitation — is more accessible than prevention.
After one suffers a stroke, immediate medical treatment is crucial for survival. The most common types of treatment include drug therapies that dissolve clots and improve blood flow, known as tissue plasminogen activator. Time is of the essence for this treatment. In order to be most effective, it must be given through an IV within three to five hours of symptoms first occurring. For patients who don’t realize they’ve had a stroke until beyond that time window, another type of treatment is surgically administered through small devices, often up into the brain, to break up or remove blood clots.
The National Institute of Neurological Disorders and Stroke (NINDS), a division of the National Institutes of Health, is leading the fight against stroke, through the research it does at the NIH campus in Bethesda, Md., and in two Washington, D.C., hospitals. NINDS has also created a clinical trials network – StrokeNet – encompassing 29 regional centers affiliated with 400 hospitals nationwide. The organization’s breakthroughs over the years have included the development of a drug called t-PA (tissue plasminogen activator), for the treatment of ischemic stroke, and it has made strides with thrombolytic and antithrombotic interventions, genetics, outreach programs and rehabilitation programs, among other things.
The best defense against stroke is a healthy, active lifestyle, but for those who have suffered one, rehabilitation techniques centering on walking, talking, eating and motor skills lead to a faster, more complete recovery.
The Allure Group, a network of six New York City nursing homes, is an example of a senior facility that has tapped into state-of-the-art robotics to help patients accomplish that goal. The Armeo Spring helps with arm paralysis, the Lokomat helps patients relearn how to walk, and the H200 helps to reawaken paralyzed muscles in the forearm and hand, using strategic electric stimulation to activate them and help begin movements again. The L300 functions similarly to the H200 but for lower extremities due to neurologic damage. The AlterG Anti-Gravity Treadmill provides reduced gravitational forces to improve lower body function.
The bottom line is that when patients are recovering from the debilitating damage caused by strokes, medicine is not enough. Patients need the very best in evidence-based rehabilitation techniques, and on that front progress is ongoing.