Stroke (cont.)

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Is surgical treatment done for strokes?

In some infrequently occuring situations, surgical treatment may be available for stroke treatment. Depending on the stroke severity and the patient's condition, neurosurgeons may decide to treat a patient with a hemorrhagic stroke. Surgical techniques may be used to stop the hemorrhage (bleeding) in the brain (for example, aneurysm clipping or coil embolization) and to remove blood that is causing increased pressure on brain tissue (decompressive craniotomy). In addition, some arteriovenous malformations (congenitally acquired tangled artery and vein connections that tend to bleed) may be treated with similar surgical techniques used by neurosurgeons.

What complications can occur after a stroke?

A stroke can become worse despite an early arrival at the hospital and appropriate medical treatment. Progression of symptoms may be due to brain swelling or bleeding into the brain tissue.

It is not unusual for a stroke and a heart attack to occur at the same time or in very close proximity to each other.

During the acute illness, swallowing may be affected. The weakness that affects the arm, leg, and side of the face can also impact the muscles of swallowing. A stroke that causes slurred speech seems to predispose the patient to abnormal swallowing mechanics. Should food and saliva enter the trachea instead of the esophagus when eating or swallowing, pneumonia or a lung infection can occur. Abnormal swallowing can also occur independently of slurred speech.

Because a stroke often results in immobility, blood clots can develop in a leg vein (deep vein thrombosis). This poses a risk for a clot to travel upwards to and lodge in the lungs -- a potentially life-threatening situation (pulmonary embolism). There are a number of ways in which the treating physician can help prevent these leg vein clots. Prolonged immobility can also lead to pressure sores (a breakdown of the skin, called decubitus ulcers), which can be prevented by frequent repositioning of the patient by the nurse or other caretakers.

Stroke patients often have some problem with depression as part of the recovery process, which needs to be recognized and treated.

The prognosis following a stroke is related to the severity of the stroke and how much of the brain has been damaged as well as complications from the impairment. Some patients return to a near-normal condition with minimal awkwardness or speech defects. Many stroke patients are left with permanent problems such as hemiplegia (weakness on one side of the body), aphasia (difficulty or the inability to speak), or incontinence of the bowel and/or bladder. A significant number of persons become unconscious and die following a major stroke.

If a stroke has been massive or devastating to a person's ability to think or function, the family is left with some very difficult decisions. In these cases, it is sometimes advisable to limit further medical intervention. It is often appropriate for the doctor and the patient's family to discuss and implement orders to not resuscitate the patient in the case of a cardiac arrest, since the quality of life for the patient would be so poor. In many cases, this decision is made somewhat easier if the patient has had a discussion with family or loved ones before an illness has occurred.

Medically Reviewed by a Doctor on 4/10/2013

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Stroke - Symptoms Question: For stroke, what were the symptoms and signs you experienced?
Stroke - Therapy Question: What therapy did you undergo after your stroke?
Stroke - Risk Factors Question: Do you have any risk factors for stroke? If so, what are they and what are your concerns?
Stroke - Recovery Question: What has recovery been like after you or a loved one suffered a stroke? Please share your story.
Stroke - Prevention Question: To reduce your risk, what dietary or lifestyle changes have you made to prevent a stroke?

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