Anti aging guide

A Stroke Occurs

 

 

How is the stroke patient affected?

Cerebral haemorrhage tends to be more catastrophic than infarction and often results in sudden death or in profound unconsciousness for a variable period. Cerebral infarction can also be rapidly fatal or cause loss of consciousness, but it is more typical to find on awaking in the morning that one leg and arm are extremely weak and that standing and walking are impossible, or perhaps that in the middle of tea the face becomes asymmetrical and the speech slurred, and standing or even sitting upright is impossible. This represents the picture of a fairly major stroke, but much less severe patterns are common in which just the speech is affected or only one limb is involved or the weakness is fairly mild.

The commonest type of speech defect following a stroke occurs when the left side of the brain has been damaged in a right-handed person, and consists in an extremely frustrating inability to find words, although such words as are available to the patient are reasonably well articulated since the main mechanisms for pronunciation are preserved. Usually, but not invariably, the spoken word is understood, and it is important not to talk about the victim in his presence as though he were incapable of comprehension.

If the other, non-dominant, side of the brain is damaged, it is common to encounter a curious combination of subtle but profoundly disabling effects, comprising neglect of the affected side of the body and perhaps of the environment as well, loss of body image, and disordered spatial perception. The result can be dramatic, as for instance in the case of a patient who tries to throw the paralysed left arm out of the bed claiming that it belongs to someone else. It may be less dramatic and the patient may simply sit with the left arm ‘lost’ and dangling under the arm-rest of the chair. Such patients, even if severely paralysed, often strenuously deny that there is anything the matter with the useless arm and leg or indeed that they are in any way unwell. They may, although possessed of perfectly sound vision, be incapable of drawing simple diagrams, or of bisecting a horizontal line anywhere near the middle, tending to totally ignore the left side of the figure. And they may recover the ability to move the limbs only to find themselves unable to dress or to find their way about. The same sort of defect, when affecting the dominant side, can cause difficulty in distinguishing between right and left, and a profound difficulty in performing even the simplest mental arithmetic.

Sensation is sometimes blunted over the paralysed arm and leg or indeed there may be predominant loss of sensation. One of the senses affected may be awareness of the position of the limb, so that it becomes hopelessly clumsy. Another sense quite often affected is vision, but in a very specific way: typically, both eyes lose just half their field of vision—the half containing objects on the same side as the paralysed limbs. Patients are often quite unaware of this and totally fail to notice anyone approaching them from that side.

Other subtle neurological disturbances can occur, but mention should perhaps be made here of three highly adverse effects, all of which may be transient and clear up in a few days or a week or two, or which may be permanent.

  1. Mental changes. A stroke may simply cause confusion, but it may also cause permanent impairment of the intellect and personality. Depression, not surprisingly, is exceedingly frequent; epilepsy is not uncommon and may need long-term medication.
  2. Urinary incontinence.
  3. Difficulty with swallowing.

 

Posted by Carol Hudgens - May 6, 2012 at 3:00 pm