The LIGHT Center, T-90, College of the Redwoods (476-4290) - April 9, 2001

A STROKE OF BAD LUCK

Most of us have known someone in our lives that has suffered a stroke.  The results of this neurological insult can range from relatively mild to profoundly debilitating.  There are two primary kinds of strokes that can occur, with a multitude of resulting temporary and permanent problems. 

All strokes are not equal.  The two main types of stroke are ischemic and hemorhagic. 

Ischemic Stroke –occurs when a blood clot blocks an artery and cuts off blood flow. This can then result in one of two types of stroke.  An embolic stroke is when the clot forms elsewhere in the body, usually in the heart, and travels up to the brain.  There it lodges in a small blood vessel and blocks off the blood flow to the brain, causing a stroke.  The second type is called a thrombotic stroke, and involves impaired blood flow to the brain due to a blockage of one or more the arteries supplying blood directly to the brain. 

Hemorrhagic Strokes – When a blood vessel in the brain “breaks” or has a “blowout”, it causes bleeding.  The bleeding results in a hemorrhagic stroke.  This type of stroke can be due to long standing high blood pressure, disorders that compromise blood vessels, and cerebral aneurysms.  An aneurysm is a weak spot in the vessel and over years it eventually breaks.  There are two types of hemorrhagic stroke including intracerebral and subarachnoid.  The intracerebral hemorrhage is bleeding that occurs from the vessels within the brain itself.  This is often due to hypertension.  In the subarachnoid hemorrhage, an aneurysm bursts in a large artery on or near the membrane that surrounds the brain.  The blood spills into the area around the brain, which is already filled with protective fluid.  The blood causes the protective fluid to become contaminated.

Neurologists will often refer to TIA’s, or Transient Ischemic Attacks.  These are small or ministrokes, which by themselves often do not have lasting effects.  However over time, as more and more of them occur, there can be lasting damage to functioning.  Damage from any kind of stroke affects many aspects of one’s life including:

·        Motor – includes speech, swallowing, muscle power and tone, movement of the face, arms, legs, reflexes, balance, gait, coordination.

·        Sensory – includes numbness, tingling, or processing of visual and/or auditory information.

·        Vision – can include cortical blindness (nothing wrong with the eye but the brain cannot “interpret” information), as well as monocular visual loss.

·        Language – can include problems with comprehension, naming, reading, writing, and fluency.

·        Cognition – can include problems in memory, attention, and orientation.

·        Affect – can include loss of energy, interest, appetite, and insomnia.

THE INEQUALITY

The effects that a stroke can have on the body and mind of its victim are largely dependent on the location of the cerebral insult, as well as the severity of the insult.  Damage to the brain resulting from a stroke is typically discussed in relation to the area of brain affected.

Left Hemisphere Stroke
Damage to the left side of the brain often results in the person losing some degree of speech and/or language functioning.  This can be in the form of aphasia, anomia (loss of ability to name objects), memory deficit, and comprehension of language.  Often there is also paresis (muscle weakness) or paralysis of a limb or two on the right side of the body.

Right Hemisphere Stroke
A right hemisphere stroke is less common.  The effects are much more difficult to define.  Often there is a visual field problem.  This is typically in the form of the brain not processing a portion of what the eye sees.  For example, left neglect, resulting from damage to the right side of the brain can cause a person to not pay attention to anything on his/her left-hand side, including food on a plate, words on a page etc.  Emotional lability is often present in a right hemisphere stroke.  This can be manifested in inappropriate affect to situations, anger outbursts, uncontrolled swearing, laughter or tears.  Finally short-term memory is a big problem for these folks.  Temporal and spatial orientation (days of the week, knowing where he/she is, where he/she lives) are all areas often impaired following this type of stroke.

Comments?          mailto:trish-blair@eureka.redwoods.edu

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Life's up and downs provide windows of opportunity to determine your values and goals. Think of using all obstacles as stepping stones to build the life you want. -- Marsha Sinetar