Back: Brain Attack - The Journey Back - A Unique Collection of Creative Writing about Stroke Recovery
Stroke is the leading cause of severe acquired adult disability in the world, but only the third leading cause of death. In Canada, Stroke afflicts an estimated 50-60,000 persons annually from whom there are 40-50,000 survivors. While much progress is currently being made in the acute treatment of Stroke, the fact remains that a Stroke profoundly affects the life of the survivor and their family.
Stroke is divided into ischemic (lack of blood flow) and hemorrhagic (bleeding) types. In North America, ischemic Stroke makes up 85% of all Strokes while 15% are hemorrhages, either intracerebral hemorrhage (bleeding into the brain substance itself) or subarachnoid hemorrhage (bleeding from a ruptured aneurysm into the space around the brain). With either form of Stroke, because the brain is quite modular in organization, the neurological disability largely depends upon what area of the brain has been damaged and the severity of that damage. Similarly, recovery depends in part upon location and extent of the brain damage.
Research into the recovery from Stroke and how to improve the recovery process is just beginning to take off. There are exciting new paradigms evolving for intensive physiotherapy and speech therapy with and without pharmacological intervention. The promise of stem cells is just emerging into the first phase 1 clinical trials. Brain recovery from Stroke and other neurological injury is an exciting novel area of research.
The current mainstay of recovery is time and therapy. Personal characteristics clearly help the recovery process. Depression limits recovery and determination, stubbornness and a will to succeed aid it. Historically, it was a common axiom on the neurological ward that recovery at 90 days was what a Stroke survivor should expect for the rest of one's life. Multiple anecdotal and now objective research confirm that this is certainly not the case. Recently, a patient of mine told me that 10 years after his Stroke, he had just begun to regain movement in his affected hand!
The message from these inspirational stories of recovery and discovery is one of perseverance and rebirth. Recovery can and does continue for years. Motor and speech tasks can be relearned. The plasticity of the human brain and its ability to reshape itself is a remarkable innate property of the unharnessed potential of our human biology. Medical progress will chip away at the immense task of improving neurological recovery after Stroke, but it will always be true that each Stroke victim will have to work extra-ordinarily hard, be determined, maintain their hope and will to live to achieve their maximum recovery post-Stroke. Recovering from a Stroke may be the hardest thing one can ever do in one's life and these tales are rich in revealing much about our potential.
Michael D. Hill
MD MSc FRCPC
Associate Professor, University of Calgary
Heart & Stroke Alberta Professorship in Stroke Research
Director, Foothills Medical Centre Stroke Unit
June, 2005