What
Is A Stroke?
A stroke
is a brain attack!
For our brain to
function, we need a constant blood supply, which provides vital nutrients and
oxygen to the brain cells. A stroke happens when the blood supply to part of
the brain is cut off and brain cells are damaged or die.
About a third of people
who have a stroke make a significant recovery within a month. But most stroke
survivors have long-term problems. It may take a year or longer for them to
make the best possible recovery. Sadly, in the most severe cases, strokes can
be fatal or cause long-term disability.
Strokes are sudden and have an immediate effect!
After stroke a person
may become numb, weak or paralyzed on one side of the body. The speech may become
slur. The person may find difficult to find words or understand speech. Some
people lose their sight or have blurred vision, and others become confused or
unsteady.
A stroke can
damage mind and body.
Strokes affect people
in different ways, depending on the part of the brain that was affected, how
widespread the damage was and how healthy the person was before the stroke. But
strokes can damage:
- bodily functions
- thought processes
- ability to learn
- and how we feel and communicate.
A stroke is always a medical emergency!
It is important to be
able to recognize the symptoms of
a stroke and to get an immediate help.
Visual Stroke Symptoms and The FAST Test
FACE,
ARMS, SPEECH, and TIME - identifies the most common symptoms of a stroke.
Facial Weakness: Can
the person smile? Has their face fallen on one side?
Arm Weakness: Can
the person raise both arms and keep them there?
Speech Problems: Can
the person speak clearly and understand what you say? Is their speech slurred?
If you see any one of
these three signs, it’s TIME to call 911.
The quicker a patient
arrives at a specialist stroke unit, the quicker he/she receives appropriate
treatment and the more likely he/she is to make a better recovery.
What Is A Stroke? - Narration and Animation by Cal Shipley, M.D.
Types
of Strokes
There are two main types of strokes.
Ischaemic strokes - happen when something blocks an artery that carries
blood to the brain.
There are several possible causes:
- a blood clot forms in a main artery to the brain
- a blood clot, air bubble or fat globule forms in a blood vessel and is carried to the brain
- a blockage in the tiny bloody vessels deep inside the brain.
Haemorrhagic strokes - happen when a blood vessel bursts and bleeds into the brain (a haemorrhage).
- a vessel bursting within the brain itself, or
- a blood vessel on the surface of the brain bleeding into the area between the brain and the skull.
Temporary symptoms may indicate a mini-stroke - Transient Ischaemic Attack (TIA). It is
the same as a stroke, except that the symptoms last for a short amount of time
and no longer than 24 hours. This is because the blockage in patient’s artery
is temporary - it either dissolves on its own or moves, so that the blood
supply returns to normal and patient’s symptoms disappear.
Although the symptoms may not last long, a TIA is still very
serious. It is a sign that there is a problem and patients are at risk of going
on to have a stroke. Because of this it
is often called a 'warning stroke' it must be taken in a serious consideration
and treated immediately.
https://www.youtube.com/watch?v=fz1sgTke_0U
Wernicke's aphasia
Wernicke's Aphasia
Therapies that target the specific area of communication a patient finds difficult are most effective.
Speech And
Language Therapy After Stroke
It is estimated that
around a third of people will have some level of communication difficulties
(called aphasia or sometimes dysphasia) after a stroke. At least 40 % of stroke
survivors will initially experience some difficulty swallowing, though many
people recover their swallow quite quickly.
- Difficulties with communication can affect patient’s social relationships, independence and self-confidence.
- Swallowing problems can put a patient at risk of infection and affect his/her enjoyment of food.
Speech and language
therapy may be helpful if a patient has the following difficulties:
- swallowing - including problems with coughing or choking when eating or drinking
- understanding language (called receptive aphasia)
- speaking, including speaking any words or saying the correct word (called expressive aphasia)
- forming words and speech sounds due to weak muscles in your mouth (dysarthria)
- moving the muscles needed for speech in the correct order and sequence (dyspraxia),
- reading (dyslexia) or writing (dysgraphia).
Speech-Language Therapy:
Working
with a Patient with Fluent Aphasia
A
survivor of an Ischaemic Stroke
Young
People can have Aphasia ( Broca's) - Jack Hurley
Aphasia
( Broca's) - Jack Hurley Update 2011
Jack Hurley - Broca's Aphasia 2013 Update
Wernicke's aphasia
Wernicke's Aphasia
A stroke should be
followed by a formal language assessment, like for instance, patient’s understanding
of yes/no questions, e.g. Do you put your
shoes on before your socks? The patient may be asked to describe the surroundings
as a test patient’s spontaneous speech or asked to repeat simple phrases or sounds.
A stroke may also cause
new problems, including loss of vision or memory, which can make communication
more difficult.
There is some overlap
between the tasks a patient will be asked to do for assessment and therapy. A
therapist should keep checking patient’s progress.
The techniques a speech
and language therapist uses to help with communication difficulties will depend
on the particular problems a patient has.
Therapies that target the specific area of communication a patient finds difficult are most effective.
For example:
- If there is a difficulty understanding the meanings of words (receptive aphasia) a patient may be asked to match words to pictures, sort words according to their meaning and judge whether words have the same meaning. These activities aim to strengthen patient’s ability to remember word meanings and link them to the spoken and written forms of words.
- If a patient presents difficulty finding the words he/she want to say (expressive aphasia) a therapy might include practicing naming pictures, judging whether words rhyme or not or repeating words a therapist says. A therapist may provide prompts, for example, making the first sound of a word or writing the first letter. A therapist may also show objects that patient can touch and see while speaking their names.
- If a patient presents weak muscles in his/her mouth, he may initially need to do exercises to help improve the muscle strength. A speech and language therapist may also give an advice on body positioning and where the tongue, lips and jaw should go when producing particular sounds.
- Difficulty controlling breathing muscles can force a patient to take a breath in the middle of a sentence. A speech and language therapist may teach a patient breathing exercises and how to plan pauses within sentences to help with this.
- One approach to help dyspraxia is to use natural melodic patterns for everyday phrases. For example, the phrase ‘Good morning!’, when said very cheerfully, has an almost musical melody. A therapist can teach a patient to use this in an exaggerated way to co-ordinate a speech. As the patient’s speech improves, the melody and rhythm cues can be gradually dropped.
- If a patient has difficulty making the right sounds in the right order to form words, a therapy should include tasks such as listening to differences between spoken words, repeating words of increasing length and developing the ability to monitor your speech.
- Some people who can do tasks involving single words, such as naming pictures, have difficulty constructing sentences. A therapy should also work on patient’s ability to understand and produce simple and complicated sentences.
An important part of
the speech and language therapist’s role involves finding alternative or
additional ways of communicating, which may include:
- gestures
- writing
- communication charts
- a letter board, or
- drawing.
For some people an
electronic communication aid may be beneficial
Reading
and writing
If a patient has problems
with speech, it is quite likely that he/she will have problems with writing (dysgraphia),
spelling and reading (dyslexia). The areas of the brain
which are important for these tasks are quite close together. Therefor a speech and language therapist may also help with reading and writing. This is because all ways of
communicating use similar abilities; for example, finding the right words and
constructing them into a sentence. However, if a patient has difficulty with
one particular way of communicating, a therapy should focus on this.
How
can my family help?
Communication problems can be frustrating and lonely for family and caregivers as well as for a person who has these difficulties.
When therapy starts, a therapist will usually give written instructions so that a patient and his/her family can practice specific exercises between sessions. It may be helpful if a family member can attend some therapy sessions to observe the exercises, and help a patient to practice them.
When therapy starts, a therapist will usually give written instructions so that a patient and his/her family can practice specific exercises between sessions. It may be helpful if a family member can attend some therapy sessions to observe the exercises, and help a patient to practice them.
The family should try to resist the temptation to
do all the talking for the patient. Many people who have had a stroke are
capable of understanding and producing speech but their speech may be slow at
first. It is easy to overwhelm someone by asking more questions before they
have had a chance to process the first one. For some people it can help to wait
as long as half a minute. To begin with, family members can try asking questions
that only need a ‘yes’ or ‘no’ answer. Later, they can increase the complexity,
just like learning a foreign language. Repetition and hard work are important.
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