Neurosciences

A: No. Almost everyone who has ever had a stroke may have been under stress or have been overworking at some time before the onset of the stroke. It is natural to think of stroke and stress as being related but they are not related.

A: No. The stroke itself has no effect on the heart, but patients who suffer a stroke may have had heart disease already, which they may or may not have known about before the stroke.

A: Partial recovery is very usual, but total recovery is less common. After a stroke four things may happen:

1. The brain cells which were badly damaged at the onset die and never recover.
2. Other cells which were only partially damaged, due to swelling of the brain, recover and start working again. This process takes place during the first few weeks after the onset of the stroke.
3. Parts of the brain which are unaffected by the stroke begin to take over the functions of the dead parts. This can occur only to a limited extent, but may continue for a long time.
4. The patient adapts to the loss of function and learns new ways of living with the damaged brain.

A: Having a stroke does not automatically mean you will have another stroke. However, the conditions which caused the first stroke- (weakness of an artery wall or blood clotting) sometimes cannot be reversed so the possibility of a second stroke is high. You can help reduce your chances having a second stroke by controlling risk factors and making healthy lifestyle choices.

At the onset of stroke, the muscles of the face, trunk, arm and leg on either the left or right side of the body are weak and relaxed. In most cases the power gradually returns, first to the leg and then to the arm. However, unless the limbs are placed in the correct position and are frequently put through a range of movements, there is a danger that they may stiffen, so that, even if the power returns, the limbs could be practically useless. This is why it is important to place the limbs in the correct position allowing recovery to take place in the best way. The simple rule is to let the leg bend but to keep the arm straight. It is also vital to treat the body as a whole, not just the paralyzed limbs in isolation.

A: Speech is affected in two ways. In some patients, speech is slurred and indistinct or even completely absent, but the patient can read, write and understand perfectly what is said. This condition is called dysarthia, and treatment usually helps with the patient’s recovery.

The other condition is much more complex. It is called dysphasia or aphasia and is due to damage to the part of the brain which controls all language processes. This can affect the patient's ability to speak, understand speech, read and write. Recovery from dysphasia can be rapid and complete, but is, in most cases, slow and incomplete, and patients and their relatives need a great deal of help from speech and language therapists and others.

A: In most stroke cases, vision is not affected. Patients who complain of visual difficulty, the fault is not in the eyesight itself, but in the interpretation by the brain of what the eye sees. In most people, the two sides of the brain each form a separate picture of half of what lies before it, and the two pictures are joined together to give a total view. When part of the brain forming one of those half pictures is damaged by a stroke, the patient sees only one half of the world depending on which half of the brain is affected. This can be perplexing for the patient and relatives, and is very disabling, but recovery, although slow, usually occurs.