Effects of a stroke
People who survive a stroke are often left with long-term problems caused by injury to their brain.
Some people need a long period of rehabilitation before they can recover their former independence, while many never fully recover and need ongoing support after their stroke.
Two of the most common psychological problems that can affect people after a stroke are:
- depression: many people experience intense bouts of crying, feel hopeless and withdraw from social activities
- anxiety: where people experience general feelings of fear and anxiety, sometimes with moments of intense, uncontrolled feelings of anxiety (anxiety attacks)
Cognitive refers to the many processes and functions our brain uses to process information. One or more cognitive functions can be disrupted by a stroke, including:
- spatial awareness – having a natural awareness of where your body is in relation to your immediate environment
- executive function – the ability to plan, solve problems and reason about situations
- praxis – the ability to carry out skilled physical activities, such as getting dressed or making a cup of tea.
A stroke can cause weakness or paralysis on one side of the body, and can result in problems with co-ordination and balance.
Many people also experience extreme tiredness or fatigue in the first few weeks after a stroke, and may also have difficulty sleeping, making them even more tired.
After having a stroke, many people experience problems with speaking and understanding, as well as reading and writing.
If the parts of the brain responsible for language are damaged, this is called aphasia, or dysphasia.
If there's weakness in the muscles involved in speech as a result of brain damage, this is known as dysarthria.
Speech and language therapy
You should see a speech and language therapist as soon as possible for an assessment and to start therapy to help you with your communication.
This may involve:
- exercises to improve your control over your speech muscles
- using communication aids – such as letter charts and electronic aids
- using alternative methods of communication – such as gestures or writing.
The damage caused by a stroke can interrupt your normal swallowing reflex, making it possible for small particles of food to enter your windpipe.
Problems with swallowing is known as dysphagia. Dysphagia can lead to lung damage, which can trigger a lung infection (pneumonia).
You may need to be fed using a feeding tube during the initial phases of your recovery to prevent any complications from dysphagia.
The tube is usually put into your nose and passed into your stomach (nasogastric tube), or it may be directly connected to your stomach in a small operation done using local anaesthetic (percutaneous endoscopic gastrostomy, or PEG).
Treatment may involve tips to make swallowing easier, such as taking smaller bites of food and advice on posture, and exercises to improve control of the muscles involved in swallowing.
Stroke can sometimes damage the parts of the brain that receive, process and interpret information sent by the eyes.
This can result in losing half the field of vision, for example, only being able to see the left or right side of what is in front of you.
Stroke can also affect the control of the eye muscles; this can cause double vision.
If you have problems with your vision after a stroke, you'll be referred to an eye specialist called an orthoptist, who can assess your vision and suggest possible treatments.
Bladder and bowel control
Some strokes damage the part of the brain that controls the bladder and bowel. This can result in urinary incontinence and difficulty with bowel control.
Some people may regain bladder and bowel control quite quickly, but if you still have problems after leaving hospital, help is available from the hospital, your GP and specialist continence advisers.
Ask for advice if you have a problem, as there are lots of treatments that can help that include:
- bladder retraining exercises
- pelvic floor exercises
- using incontinence products.