Can life after a stroke help with rehabilitation?

Factors influencing recovery

Social and psychological factors play a huge role. The patient must decide for himself whether to return to his previous life.

Unfortunately, only about 8% of people can fully return to work. Others remain limited in their ability to work for the rest of their lives.

A person should avoid bad habits. Unfortunately, smoking, drinking alcohol or obesity are risk factors that will negate a favorable prognosis (read more about who is at risk in this material).

Doctors assess the condition of actor Yanina

Alexey Yanin. Photo: alex-yanin.narod.ru

In a closed group on the social network Facebook dedicated to the popular actor Alexei Yanin, who fell into a coma after a stroke, his wife told the latest news. Daria reported that the doctors decided to hold a consultation regarding the artist’s serious condition .

“Our dear relatives and friends. Alexey’s condition is serious, now we are waiting for a consultation of doctors on his condition. No changes. We try to spend time with him more often, talk so that he feels our presence . Thank you for waiting for the news with us,” she wrote.

Earlier, Daria Yanina stated that she did not intend to flaunt her misfortune by participating in various television programs. “Our dear loved ones! ATTENTION! We officially declare that we will not participate in any television programs . We appeal to journalistic ethics and ask you not to besiege the phones of your loved ones and friends! We will post all the information about Alexey’s condition daily in this group! We also did not agree to media fundraising marathons. Anyone who wants to help can do so in a group. Thank you very much to everyone who responded and prayed for us. This is the most important thing now, it gives strength to Alexey and all of us. We are fighting for him, and he will cope!” – she said.

Alexey Yanin became ill on the evening of May 6 during a meeting with a friend. At about 03:00, his wife urgently called an ambulance, and the actor was taken to City Clinical Hospital No. 1 named after Pirogov. According to Daria, due to the protracted holidays, doctors scheduled the operation only for May 12, but during this time Alexey’s condition worsened sharply. He was transported to another hospital, where an emergency operation was performed.

The wife noted that in recent years the actor had a very busy work schedule . during which he made many flights. According to Daria, this could affect his health. Doctors are doing everything possible to save the artist.

Survival Statistics

According to statistics for 2018, the survival rate of patients after a cerebral stroke is approximately 65-70%. Another 70% of this figure become permanently disabled (read more about the consequences of a stroke here).
And only 8% of people can return to a full life and even work. By the way, age directly affects survival. So, the younger the age of the person who suffered a stroke, the greater the likelihood of returning to normal life.

Adaptation

The key to normal continuation of life is adaptation to new conditions and a new self after a stroke. It covers all aspects of the patient’s life. He needs to learn to move again, take care of himself, believe in his own strength, and sometimes he needs to learn to think and speak again.

Emotions

The worst thing that relatives of a stroke survivor can face is his reluctance to recover, depression, despondency, and disappointment.

A person stops seeing the future, suffers from pain, discomfort, and considers himself a burden. Often, experiences of disappointment are replaced by aggression towards oneself and loved ones. Suicide attempts are possible. This range of feelings and emotions is possible if a person is aware of what is happening to him.

Dependence on the location of the lesion

1. A favorable prognosis awaits patients who have unilateral lesions from the primary lesion. They can recover faster and have all the prerequisites for returning to work.
2. If there is bilateral localization, then favorable and unfavorable prognoses correlate 50 to 50. This may be due to a combination of locations of the affected areas of the brain.
3. When the primary focus is on the pons of the brain, then, unfortunately, negative dynamics are observed here during recovery and treatment.

We can conclude that the smaller the volume of brain damage, the more favorable the prognosis for recovery will be.

Prognosis for a third stroke

Stroke is widespread throughout the world. It is the third leading cause of death according to WHO. Among brain diseases associated with changes in blood vessels, the proportion of second and third strokes is more than 30%.

The reasons for the development of repeated cerebrovascular accidents and the prognosis for those who have suffered a third stroke are discussed below.

Making a prognosis for a third stroke

With any illness, a person wonders when he will get better. In the case of ischemic or hemorrhagic brain damage, the patient and his relatives are interested in how much self-care skills, communication, and intellectual abilities will suffer during the illness and how quickly they will recover.

The third cerebrovascular accident does not occur in the same way for everyone. For some, this can be a death sentence, and for others, a disease that will require serious treatment and long recovery.

Some patients may completely lose their intellectual abilities as a result of the disease, while others may regain the skills they had before the disease.

The prognosis for rehabilitation after three strokes depends on a number of factors

Indicators that form the prognosis for the development of a third stroke:

• Unchangeable factors. These include the severity of the stroke, its type, location, and the patient’s age.
• Variable factors: blood pressure, some biochemical blood parameters, body temperature.

Control of the second group of factors creates opportunities for treating patients and gives them a chance for recovery.

The very concept of “prognosis” for a third stroke is a complex concept. It brings together the circumstances that together determine a patient's chances of life and recovery. These are the circumstances:

• Clinical outcome of the disease.
• Functional outcome.
• Prospects and duration of recovery.
• Probability of death.
• The likelihood of complications.

Based on the time elapsed since the onset of the disease, the prognosis is divided into:

• Early. This is the first month after the illness.
• Late. A month after the onset of the disease.

Early prognosis for cerebrovascular accidents

In the first hours and days, the doctor assesses the patient’s condition using several indicators:

• The number of points on the stroke scale (NIHSS scale - American National Institute of Health).
• Time from the onset of the disease.
• Magnetic resonance imaging data.
• The volume of affected brain tissue on magnetic resonance imaging.

MRI will help diagnose the patient’s condition and give a prognosis for his rehabilitation.

This is, in fact, an attempt to predict whether a person will survive the first month of illness or not. The sum of points scored by the patient according to these criteria allows the doctor to make an early prognosis for the clinical outcome of the third stroke.

But there are conditions that can affect recovery. Based on research, they were determined by the National Institute of Health:

• Young age.
• Having a spouse.
• Lower body temperature in the acute period of the disease.
• Positive dynamics in the first week of the disease.

They accelerate the recovery of motor and speech skills after ischemia.

Late forecast

Using clinical data, taking into account favorable or unfavorable circumstances, a month after the onset of the disease, the doctor re-evaluates the patient’s condition. At this stage, the chances of recovery are considered taking into account the characteristics of the disease in that person. The late prognosis for patients with a third stroke will include all levels of manifestation of the consequences of the disease:

• Clinical. Movement, sensitivity, speech and vision disorders, behavioral and mood disorders.
• Domestic. Difficulty moving and self-care. Difficulty performing complex activities - driving a car, going to a store or savings bank.
• Social. After the third stroke, a person cannot perform previous social functions.

One month after the stroke, a final prognosis for its recovery can be given.

At this time, a person’s rehabilitation program is formed. They clarify the medications he will take at home. They teach relatives the specifics of care. And they voice the results that the joint efforts of doctors and the patient will lead to.

Ideally, clinical recovery should lead to complete everyday and social recovery, but this occurs only in 15% of cases.

Separately, there are signs that predict an unfavorable outcome:

• Severe disturbances of consciousness and perception.
• Persistent paralysis of the limbs.
• The appearance of urinary incontinence.

Age dependent

Depending on the individual characteristics of the patient’s age group, we can talk about different prognoses for life.

In children and adolescents

Children have a unique body feature. Intact brain cells can take over the functions of dead cells. Children are more learnable after suffering a stroke. They can again use their limbs for their intended purpose and speak.

However, the recovery process is quite slow. With the right approach and treatment, about 70% of children who have suffered a stroke can function safely in society, becoming productive members of society.

But a favorable prognosis is possible only if treatment measures are taken in a timely manner. And also if a minimal area of ​​the brain was affected. If the lesions are localized throughout the organ and occupy a large area, then there is no need to talk about a capable state.

In middle-aged men and women

The recovery period in middle-aged patients is quite favorable compared to representatives of the older generation.
The fatal outcome is minimal, only 5%. There is a possibility of restoration of speech and motor functions. The likelihood of returning to activity in daily life also increases. Most patients, with proper treatment and the desire to recover, return to their normal lives after some time.

The main thing is to choose the right rehabilitation measures, which must be applied from the very first days when an acute circulatory disorder in the brain was recorded.

Read about the causes of stroke in people of different ages and genders here.

In older people 80-90 years old

For older patients, the prognosis is rarely positive. The risk of death increases. Most often, after a massive cerebral stroke has occurred, a patient who is 80-85 years old or older completely falls into a coma. It stays in this state for 3 to 7 days, after which it dies without leaving it. Due to the weakening of the body, the chances of survival are very small.

Important! Additionally, other diseases can aggravate the situation, making death the only possible prognosis.

Read about how long people live with damage to the right side and other consequences here.

Chances of surviving after repeated hemorrhages

How many times can one person have?

Doctors believe that the critical mark is three strokes. After this, pathological changes begin to occur in the body, which will lead to death.

However, practice knows cases of four, even five strokes. In order to endure such a number of blows, a person must initially be in good health.

Each subsequent blow indicates the ineffectiveness of the chosen treatment.

Stroke is a health-threatening disease, so it is important to know about its types, signs, course of the disease and prevention.

Consequences

A stroke is dangerous due to its consequences:

• Motor disorders. In severe cases, complete immobilization and paralysis are observed, and the person becomes bedridden. In milder cases there is a violation of the range of motion of joints, gait, and muscle weakness. Convulsions and involuntary movements of the hands are noted.
• Impaired coordination of movements. A person cannot maintain balance, falls, and cannot support his body even when sitting.
• Sensitivity disorders. The patient feels a burning sensation, numbness, and tingling in the limbs. In some cases, he does not feel any pain when touched, pricked, or burned.
• Deterioration in the functioning of the sensory organs. There is weakening of vision and hearing. With severe pathology, the patient may remain blind.
• Weakening of cognitive, thinking functions, speech. A person becomes distracted, inattentive, suffers from memory disorders, loses the ability to analyze, critically relate to the world around him, perform mathematical operations, and read. With extensive lesions, complete loss of cognitive abilities is possible. Patients often live in their own world. There is a loss of speech, the ability to speak, and to understand words addressed to him. Such disorders manifest themselves mainly in left-sided lesions.
• Emotional disorders. A person suffers from depression and hopelessness. Many patients become aggressive. This happens due to loss of control on the part of the left hemisphere.
• Disorders of the pelvic organs. There is urinary incontinence, involuntary defecation, or, conversely, constipation.
• Development of chronic diseases. The heart, respiratory organs, gastrointestinal tract, and kidneys suffer.
• Loss of ability to care for oneself. Due to the inability to move, to be critical of one’s actions, and loss of self-control, the patient often needs constant care.