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What we’re learning about stroke
The brain’s apparent ability to heal itself offers new hope for rehabilitation

Know the signs of stroke

Stroke is a medical emergency. If you or someone you’re with experiences any of the following symptoms, call 911 immediately for medical assistance:

  • sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • sudden confusion, trouble speaking or understanding
  • sudden trouble walking, dizziness, loss of balance or coordination
  • sudden trouble seeing in one or both eyes
  • sudden severe headache with no known cause

More stroke insights

  • A cool therapy. Danish researchers have found that lowering a stroke victim’s body temperature by about 1°C and maintaining the cooler temperature for six hours can minimize brain damage and increase the chances of survival. A medication that controls shivering allowed the researchers to lower the patients’ body temperatures without using anesthesia. How does the therapy work? Researchers believe the cool blood sent to the brain helps prevent further destruction of brain tissue. An upcoming clinical trial in Denmark, Norway and Sweden may provide more answers.
  • Aspirin essential. Researchers analyzing the results of two large stroke trials found that an aspirin given to an ischemic stroke victim immediately upon arrival at the emergency room can prevent recurrent strokes in the period immediately following the first stroke as well as in the days and weeks to come. Ischemic strokes are caused by clots that block blood flow to the brain.
  • Lifting depression, promoting recovery. Stroke can cause people to have difficulty with orientation, memory, language and hand-eye coordination. For years, doctors attributed these problems to the physical damage sustained by the brain as a result of stroke. But now doctors believe that treating poststroke depression with antidepressants can help patients recover many of their lost functions. If you or a loved one has suffered a stroke, be aware that depression should not go untreated.
  • Medication enhances speech therapy. Piracetam, a drug that has been around for three decades, may be able to help stroke patients recover memory and language skills more effectively than speech therapy alone. It works by enhancing brain cells’ ability to communicate with each other.

The preventive path

Avoiding atherosclerosis is the best way to avoid stroke. These basic steps can keep arteries clear:

  • Keep your blood pressure below 120/80 mm Hg.
  • If you have diabetes, maintain a tight rein on blood sugar levels.
  • Control cholesterol levels. Cholesterol-lowering medications, particularly statins, can cut stroke risk, especially in those who have already had a stroke.
  • If your doctor finds you are at high risk for stroke, ask if antiplatelet drugs may be helpful. They prevent blood clots from forming by inhibiting platelets, compounds that cause blood cells to stick together.

A clot lodges in an artery supplying blood to the brain, impairing proper circulation and depriving brain tissue of needed blood. Or a blood vessel in the brain ruptures, causing blood to pool in the brain cavity. In either case, the result is a stroke.

For decades, it was believed that once brain cells died they were irretrievably lost—as was any hope of regaining use of a paralyzed limb. Consequently, rehabilitation focused on teaching stroke victims to compensate for lost function by relying on an unaffected limb or by using special feeding utensils, for example.

Although this approach helps stroke victims regain a sense of independence, all too often the affected limbs remain unchallenged. After a while, a patient may give up trying to move the paralyzed arm or leg in a kind of “learned helplessness.”

However, University of Alabama scientists have found that a technique called constraint-induced movement (CIM) therapy can prod the affected part of the brain to rewire itself, making it possible for stroke victims to regain at least partial use of a paralyzed limb.

The researchers restrained the nonparalyzed arms of 13 stroke patients with a splint and a sling, encouraging them to use their weakened arms. The restraints were worn for eight to 10 hours a day for 12 days. On eight of those days, the patients were trained to use the paralyzed arm to carry out increasingly difficult tasks, such as picking up beans one by one. The exercises lasted about six hours a day.

Although CIM therapy can be difficult, the rewards can be significant: The study subjects regained a significant percentage of their lost function in less than two weeks. Six months later, the benefits persisted, and more remarkable, the therapy proved effective even in those who had experienced a stroke several years before the study.

© 2014 Dowden Health Media