Effects of a Stroke

If you missed last weeks post, you can find it here.

Each stroke is different.  How well you recover from a stroke depends upon many factors including how much and what parts of your brain were damaged and your health before the stroke.  The work you do with your stroke rehabilitation team and the support from family and friends is also important to your recovery.

A stroke damages the brain and causes a sudden loss of brain function.  Because your brain controls everything you do, say and think a stroke can have a lot of different effects.

The cerebrum

The cerebrum is responsible for controlling movement and sensation, speech, thinking, memory, sexual function and regulation of emotions.  It is divided into right and left sides or hemispheres.

Effects of left hemisphere strokes

• Weakness or paralysis on the right side of your body.  Trouble reading, talking, thinking or doing math.
• Your behaviour may become more slow and cautious than usual.
• You may have trouble learning or remembering new information.

Effects of right hemisphere strokes

• Weakness or paralysis on the left side of your body.
• Vision problems
• Problems distinguishing distance, depth, between up and down, or between front and back.  this can make it hard to pick up objects, button a shirt, or tie your shoes.
• Problems understanding maps.
• Problems with short-term memory.  You may be able to remember something that happened several years ago, but not something you did a few minutes ago.
• Forgetting or ignoring objects or people on your left side (this is called neglect).  You may  even ignore your own left arm or leg.
• Judgement difficulties, such as acting impulsively or not realizing your own limitations.

Brain Stem strokes 

• This is an uncommon type of stroke.  The brain stem is the area at the very base of the brain, right above the spinal cord.  if you have a stroke in the brain stem, you can have problems with:
• Breathing and heart function.
• Body temperature control
• Balance and coordination
• weakness or paralysis of your arms and legs on both sides of the body.
• Chewing, swallowing and speaking.
• Vision.

Strokes in the cerebellum

Although strokes are less common in the cerebellum. (The part of the brain at the back of the skull, its function is to coordinate and regulate muscular activity) The effects can be severe.  Four common effects of strokes in the cerebellum include:

• Inability to walk and problems with coordination and balance (called ataxia).
• Dizziness
• Headache.
• Nausea and vomiting.

Will a stroke change my life?

Any major illness will change your life.  Almost all stroke survivors recover to some extent. Most stroke survivors go on to lead full, meaningful lives. 

Over several Wednesdays I will offer information on the following - 

• Anatomy of the Brain, √  Anatomy of the Brain, part 2 √
• Ischemic Stroke √ 
• Transient Ischemic Attack (TIA or mini-stroke) - part 1 √  Transient Ischemic Attack (TIA or mini-stroke) - part 2 √
• Hemorragic Stroke √
• Stroke in children (Paediatric stroke) - Causes √ 
• Stroke in Children (Paediatric Stroke) - Diagnosis, Treatment and Rehabilitation √ 
• Effects of a Stroke √ 

 All information contained in this post was obtained, with permission, from the Heart and Stroke Foundation  website. Please visit their site for more information.

Monica

Disclaimer

The material provided on this site is designed for information and educational purposes only. The materials are not intended to be a self diagnostic and/or self treatment tool. I encourage you to use this information as a tool for discussing your condition with your health practitioner.

Stroke in children (Paediatric stroke) ~ Diagnosis, Treatment and Rehabilitation ~

(If you missed last week's post, you can find it here.)

Diagnosis of paediatric stroke

A quick diagnosis is important to minimize risk for brain damage. Doctors rely on imaging machines and other tests to see what has happened in a child’s brain.  

• Computed Tomography (CT) scan uses X-rays to take a detailed picture of the affected area of the brain. A CT scan will confirm whether or not the child has had a stroke, what kind of stroke it is and where in the brain it occurred.  
• Magnetic Resonance Imaging (MRI) uses magnetic radio waves to create an image of the brain. It provides greater visual details than a CT scan.  
• Cerebral Arteriogram uses a special dye injected into the arteries of the brain and an X-ray is then taken.  
• Echocardiogram uses sound waves to take pictures of the heart to see whether there are problems with the heart valves or other heart functions that may be creating blood clots.  
• Blood tests may also be ordered to find out whether your child has a blood-clotting disorder.  
• Lumbar puncture (also known as a spinal tap) to find out if there are signs of infection or inflammation in the nervous system.

Treatments of stroke in children

In children who have had a hemorrhagic stroke, treatment focuses on stabilizing the child (controlling blood pressure and body temperature, and helping them breathe), and treating the hemorrhage itself. Children who have had an ischemic stroke may need to go on blood thinners.

Treatment for hemorrhagic stroke Kids who have had a hemorrhagic stroke will be looked after by the vascular neurosurgery team. Surgical options may include microsurgery to clip the aneurysm or remove the abnormal vessels.

Treatments for ischemic stroke The goal of treatment in ischemic stroke is to reduce damage to the brain and prevent another stroke. If your child has been diagnosed with an ischemic stroke, doctors will most likely prescribe a blood thinner. These include: 

• Coumadin (warfarin) , given by mouth
• Heparin, given by injection into a vein
• Low molecular weight heparin, given by injection under the skin
• Acetylsalicylic acid (Aspirin or ASA), given by mouth
• Clopidogrel (Plavix), given by mouth

Once a child has been treated for their initial stroke symptoms, they will be assessed to see how the stroke may affect them in the longer term. The healthcare team will monitor reflexes, eye movements, speech skills, swallowing and other body functions. The team may also administer tests to find out how well your child is doing in processing and reacting to light, pictures, sound and touch.

Newborns generally don’t require treatment for stroke, although they may be treated for heart problems, if that is the source of their illness.

What are the possible effects of a stroke? 

Stroke often causes after-effects in children. They include:  

• weakness on one side of the body (hemiparesis)
• paralysis on one side of the body (hemiplegia)
• one-sided neglect, where the child ignores the weaker side (unilateral neglect)
• difficulty with speech and language (aphasia)
• trouble swallowing (dysphagia)
• vision problems (decreased field of vision or perception)
• loss of emotional control and mood changes
• problems with memory, judgment or problem-solving (cognitive changes)
• behavioural or personality changes

Physical effects usually occur on the opposite side of the body from where the stroke occurred. For instance, children who have had a stroke affecting the left side of their brain may have weakness or paralysis on the right side of their body. The left side of the brain controls reading, talking, thinking and doing math, so these skills could be affected.

On the other hand, children who have had a stroke affecting the right side of their brain, may have paralysis or weakness on the left hand side of their body. The right side of the brain controls skills such as buttoning a shirt or tying shoes, as well as memory.

In children who have experienced a stroke, changes in physical abilities may be immediately apparent, but changes in cognition and behaviour tend to be discovered over time. Often children do recover faster than adults because their brains are still growing. This is called plasticity. If children are quite young when they have a stroke, the extent of their deficits may not become apparent until they are older. For example, a reading problem may not be discovered until your child is in grade 1.

You and your child may feel overwhelmed, angry, depressed or frightened, which are all normal reactions. Speak to your hospital’s healthcare team about counselling options for your child and yourself.

What rehabilitation programs are available?

The purpose of rehabilitation is for your child to recover physical functions such as walking or reading. Getting help as soon as possible after the stroke maximizes recovery in children. Children are likely to regain the most function in the first six months. They may continue to improve for two years or more. Speak to your hospital’s healthcare team about rehabilitation options.

Over several Wednesdays I will offer information on the following - 

• Anatomy of the Brain, √  Anatomy of the Brain, part 2 √
• Ischemic Stroke √ 
• Transient Ischemic Attack (TIA or mini-stroke) - part 1 √  Transient Ischemic Attack (TIA or mini-stroke) - part 2 √
• Hemorragic Stroke √
• Stroke in children (Paediatric stroke) - Causes √ 
• Stroke in Children (Paediatric Stroke) - Diagnosis, Treatment and Rehabilitation √ 
• Effects of a stroke

 All information contained in this post was obtained, with permission, from the Heart and Stroke Foundation  website. Please visit their site for more information.

Monica

Disclaimer

The material provided on this site is designed for information and educational purposes only. The materials are not intended to be a self diagnostic and/or self treatment tool. I encourage you to use this information as a tool for discussing your condition with your health practitioner.

Stroke in children (Paediatric stroke) ~ Causes ~

(If you missed last week's post, you can find it here.)

Stroke can happen at any point in a person’s lifetime, from infancy and childhood to adulthood. A stroke is caused by the interruption of normal flow of blood to the brain, either by a blockage or a rupture in the blood vessels. When a part of the brain doesn't receive its regular flow of blood that carries vital nutrients and oxygen, brain cells die, causing a loss of brain function.

The age of the child at the time of stroke makes a difference in how doctors identify and treat the problem. Stroke can occur in these three different age groups: 

• The prenatal phase, or in the womb
• The first 28 days of life, or newborn phase
• The infant years up to 18 years of age 

Stroke is relatively more common in the first two age groups, occurring in up to one in every 4,000 live births. In the third age group, stroke is more rare, only affecting about five out of every 100,000 children each year in Canada.

The location in the brain the stroke takes place will determine the extent of the damage and the after-effects, if any.

Children may experience two types of stroke: hemorrhagic stroke (rupturing of blood vessels), or ischemic stroke (blockage caused by a blood clot).  

 ~The causes of stroke in children ~

The reasons why stroke occurs in children are varied and include malformations of the blood vessels and rare diseases. Here are the most common causes:

Hemorrhagic stroke occurs when a blood vessel ruptures in the brain. In children, it may be due to a weakened or malformed artery. If an artery wall is weak, blood can collect in the wall causing it to balloon (aneurysm). If the pressure builds, the aneurysm can rupture. When this happens, two problems arise. One is that blood flows into areas of the brain where it doesn’t belong, and second, blood fails to reach its destination, depriving that part of the brain of oxygen and nutrients.

The causes of hemorrhagic stroke in children include: 

• an artery malformation or disorder
• a brain tumour
• drug or alcohol abuse by the mother (rare)

Ischemic stroke is usually caused by a blood clot in the brain. The leading risk factors for ischemic stroke in children include:  

• Heart disease When children are born with a heart defect (congenital heart disease), their risk of having a stroke is increased. Heart disease, such as rheumatic heart disease, can also be acquired later in childhood. Stroke is not usually the first sign of heart disease. Often heart disease has been diagnosed before the child has a stroke. 
• Blood-clotting disorders Blood-clotting disorders, also known as prothrombotic disorders, cause the blood to thicken and clot faster. These disorders can be present at birth or acquired later on. A child can be born with a genetic mutation that makes the blood clot faster. Stroke is often the first sign of a blood-clotting disorder. Some illnesses, such as meningitis, sepsis, diarrhea, dehydration or an iron deficiency, can also lead to a blood clotting disorder.  
• Irregular arteries A child can have a stroke because the arteries in the brain are irregular or narrowed. This is called arteriopathy. Often, children are born with this problem, but it often goes undetected. In these cases, stroke is the first sign of an irregular artery problem. Children with irregular arteries need to be monitored very closely by their stroke clinic team because 25% of them will experience another stroke. 
• Viruses Stroke can also be indirectly caused by a virus. One of the culprits is the chicken pox virus. Once a child is infected, the virus can lie dormant in the body. When the virus is triggered, it can attack an artery in the brain.  
• Other risk factors Children are also at higher risk of having a stroke if they have any of the following risk factors: 
  • heart or brain surgery
  • moyamoya disease
  • sickle cell disease
  • autoimmune disease that attacks arteries in the brain
  • trauma to the brain or neck
  • leukemia
  • migraine headaches with aura
  • metabolic illness

Up to 20% of paediatric stroke cases have no known cause. This is an area of active medical research.

Over several Wednesdays I will offer information on the following - 

• Anatomy of the Brain, √  Anatomy of the Brain, part 2 √
• Ischemic Stroke √ 
• Transient Ischemic Attack (TIA or mini-stroke) - part 1 √  Transient Ischemic Attack (TIA or mini-stroke) - part 2 √
• Hemorragic Stroke √
• Stroke in children (Paediatric stroke) - Causes √ 
• Stroke in children (Paediatric stroke) - Diagnosis, Treatment and Rehabilitation
• Effects of a stroke

 All information contained in this post was obtained, with permission, from the Heart and Stroke Foundation  website. Please visit their site for more information.

Monica

Disclaimer

The material provided on this site is designed for information and educational purposes only. The materials are not intended to be a self diagnostic and/or self treatment tool. I encourage you to use this information as a tool for discussing your condition with your health practitioner.

STROKE - Hemorrhagic stroke

(If you missed, Transient Ischemic Attack (TIA or mini-stroke), part 2 - you can find it here)

Hemorrhagic stroke -

About 20 per cent of strokes are hemorrhagic, which means they are caused by uncontrolled bleeding in the brain. This bleeding interrupts normal blood flow in the brain and by flooding the brain, kills brain cells.

There are two main types of hemorrhagic stroke:

Subarachnoid hemorrhage is uncontrolled bleeding on the surface of the brain, in the area between the brain and the skull.

Intracerebral hemorrhage occurs when an artery deep within the brain ruptures.

Both types of hemorrhage can be caused by structural problems with the blood vessels in the brain. These include:

Aneurysm: A weakened area in the blood vessel wall of the blood vessel that fills with blood and bulges. High blood pressure or trauma can cause the bulge to rupture, resulting in uncontrolled bleeding into the brain.

AVM (Arteriovenous Malformation): A malformation of the brains blood vessels usually present at birth, that causes the artery walls to be weak and increases the risk of hemorrhagic stroke.

Over several Wednesdays I will offer information on the following - 

• Anatomy of the Brain, √  Anatomy of the Brain, part 2 √
• Ischemic Stroke √ 
• Transient Ischemic Attack (TIA or mini-stroke) - part 1 √  Transient Ischemic Attack (TIA or mini-stroke) - part 2 √
• Hemorragic Stroke √
• Stroke in children (Paediatric stroke) - next Wednesday
• Effects of a stroke

 All information contained in this post was obtained, with permission, from the Heart and Stroke Foundation  website. Please visit their site for more information.

Monica

Disclaimer

The material provided on this site is designed for information and educational purposes only. The materials are not intended to be a self diagnostic and/or self treatment tool. I encourage you to use this information as a tool for discussing your condition with your health practitioner.