Living With Stroke: Survival And Recovery

Strokes are a life-threatening medical emergency that occurs when there is an interruption in blood flow to the brain. They are the fifth leading cause of death in the United States and a leading cause of long-term disability. While strokes can result in death, it is possible to survive them, and the chances of survival and recovery improve with rapid medical attention. The recovery process can be lengthy and may involve physical, occupational, and speech therapy.

Immediate medical attention is critical to prevent permanent damage or death

Strokes occur when there is an interruption in blood flow to the brain, which can be due to blocked arteries or bleeding in the brain. Without a steady supply of blood, brain cells in the affected area begin to die from a lack of oxygen. The longer the brain is deprived of oxygen, the greater the risk of permanent brain damage or death.

Recognising the signs of a stroke is crucial. The acronym BE FAST is a helpful tool to identify the warning signs:

• Balance: Watch out for a sudden loss of balance.
• Eyes: Look for a sudden loss of vision or double vision in one or both eyes.
• Face: Ask the person to smile and observe for drooping on one or both sides of the face, indicating muscle weakness or paralysis.
• Arms: Check for muscle weakness by asking the person to raise their arms; if they have one-sided weakness, one arm will sag.
• Speech: Strokes often cause difficulty speaking or understanding speech.
• Time: Act fast and call emergency services immediately if you observe any of the above signs.

If you or someone you know is experiencing stroke symptoms, call emergency services right away. The faster treatment is administered, the better the chances of recovery and minimising permanent damage.

Strokes are the fifth leading cause of death in the US

Strokes are the fifth leading cause of death in the United States, and a leading cause of long-term disability. Every year, about 795,000 people in the US have strokes, and 137,000 of those people die. This equates to a death from stroke every 3 minutes and 11 seconds. Stroke is also a leading cause of serious long-term disability, with more than half of survivors aged 65 and older experiencing reduced mobility.

The risk of having a stroke varies with race and ethnicity. The risk of a first stroke is nearly twice as high for non-Hispanic Black adults as it is for White adults. Non-Hispanic Black adults and Pacific Islander adults have the highest rates of death from stroke. Stroke risk also increases with age, but strokes can occur at any age. In 2014, 38% of people hospitalized for stroke were under 65.

The death rate for stroke in the US decreased from 41.1 per 100,000 in 2021 to 39.5 per 100,000 in 2022. However, the target death rate for 2022 was 33.4 per 100,000. This indicates that, despite progress, there is still work to be done in reducing stroke deaths.

Interventions to lower people's risk of stroke are critical to reducing stroke-related deaths. These include improving blood pressure, diet, and physical activity. Raising awareness of stroke signs and symptoms and improving stroke management can also help reduce deaths and disabilities related to stroke.

Strokes occur when the blood supply to the brain is disrupted, killing brain cells. The three main types of stroke are ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA). Ischemic strokes are the most common type, resulting from a clot that prevents oxygen-rich blood from flowing into the brain. Hemorrhagic strokes are caused by bleeding or rupturing blood vessels, which puts pressure on and kills brain cells. TIAs are often referred to as ministrokes, and while they are not life-threatening, they are a sign of significant health problems that increase the risk of a major stroke in the future.

Strokes can lead to serious disabilities or inability to live independently

A stroke is a life-threatening condition that occurs when there is an interruption in the blood supply to the brain, resulting in brain cells dying due to a lack of oxygen. Strokes can lead to serious disabilities and can affect individuals' ability to live independently. The impact of a stroke on a person's functionality and independence depends on several factors, including the type of stroke, its severity, the treatment used, age, and overall health.

Ischemic strokes, which are caused by blocked blood vessels in the brain, account for about 80% of all strokes. They can lead to paralysis, cognitive problems, speech and language difficulties, emotional issues, and sensory changes. Hemorrhagic strokes, on the other hand, are caused by bleeding in or around the brain and can result in severe headaches, seizures, and coma.

The severity of a stroke plays a significant role in the likelihood of long-term disabilities. A severe stroke may leave an individual with serious disabilities, impacting their ability to perform daily tasks such as dressing, bathing, eating, drinking, reading, and writing. They may also experience emotional issues such as depression and anxiety, which can further hinder their ability to live independently.

Age is another critical factor influencing independence after a stroke. Older adults, especially those over 65, tend to have lower survival rates and higher risks of disability after a stroke. Additionally, individuals with pre-existing health conditions, such as high blood pressure, high cholesterol, or Type 2 diabetes, are more likely to experience severe strokes and subsequent disabilities.

The location of the stroke also matters. Strokes affecting the brain stem, for example, are associated with more severe complications and can have a significant impact on a person's ability to live independently.

Immediate medical attention is crucial in improving the chances of survival and reducing the risk of permanent disabilities after a stroke. Receiving treatment within three hours of the onset of stroke symptoms significantly enhances the possibility of recovery.

While some individuals may make a full recovery and regain their independence, others may require long-term rehabilitation and continued support to adapt to their new circumstances.

The risk of a second stroke is much higher after the first

The Risk of a Second Stroke After the First

After a stroke, the chance of having another stroke increases significantly. About one in four stroke survivors will experience another stroke within the next five years. This heightened risk underscores the importance of implementing preventive measures to lower the likelihood of a recurrent stroke.

The risk of a second stroke is particularly elevated in the first year after the initial stroke, with a 15-fold increase in risk compared to the general population. While the average annual risk decreases to about 4% after the first year, it remains higher than the general population's risk for several years. Therefore, initiating secondary prevention strategies as soon as possible and maintaining them for an extended period is crucial to reducing the chances of another stroke effectively.

Identifying the cause of the first stroke is of utmost importance in developing targeted prevention strategies. For instance, understanding whether the stroke was caused by blocked blood vessels, high blood pressure, diabetes, irregular heart rhythms, or other factors helps determine the most effective preventive measures. Managing vascular risk factors, such as high blood pressure, Type 2 diabetes, cholesterol, and triglyceride levels, is a critical aspect of reducing the risk of a second stroke.

Lifestyle modifications also play a pivotal role in stroke prevention. This includes adopting a healthier diet, increasing physical activity, quitting smoking, and improving sleep habits. These changes not only help lower the risk of a second stroke but also contribute to overall health and well-being.

Additionally, it is essential to seek medical advice and adhere to prescribed medications to effectively manage stroke risk factors. Healthcare professionals may recommend specific treatments, such as blood-thinning medications or antiplatelet drugs, to reduce the likelihood of blood clots and subsequent strokes.

The type of stroke, its severity, treatment used, age, and overall health are factors in survival rates

Survival Rates After a Stroke

The survival rate after a stroke depends on multiple factors, including the type of stroke, its severity, the treatment used, the patient's age, and their overall health.

Type of Stroke

The three main types of stroke are:

• Ischemic stroke: The most common type, ischemic strokes are caused by a clot that prevents oxygen-rich blood from reaching the brain.
• Hemorrhagic stroke: This type of stroke is caused by bleeding or rupturing of blood vessels, which puts pressure on and leads to the death of brain cells.
• Transient ischemic attack (TIA): Known as a ministroke, a TIA's symptoms usually last only a few minutes to an hour.

Hemorrhagic strokes have a higher death rate than ischemic strokes in the first 30 days after the event. A 2018 study showed that at the five-year mark, 79% of people who had a hemorrhagic stroke had died or were physically dependent, compared to 70.6% of those who had an ischemic stroke.

Severity

The severity of a stroke depends on the extent of brain damage and the areas of the brain affected. A severe stroke can lead to serious disabilities or death. Even with good treatment and care, a severe stroke may leave a person with serious disabilities or unable to live independently.

Treatment Used

Access to certain treatments, such as tissue plasminogen activator, can improve the chances of recovery. Additionally, treating the underlying causes of a stroke, such as high blood pressure, high cholesterol, and diabetes, can help prevent another stroke from occurring.

Age

Age is a significant factor in long-term survival after a stroke. Older adults tend to have lower survival rates, with people aged 85 and older having the highest risk of dying due to a stroke.

Overall Health

A person's overall health before a stroke also affects their survival rate. People with pre-existing conditions such as cerebrovascular disease, heart disease, high blood pressure, high cholesterol, obesity, or diabetes are at a higher risk of dying from a stroke.

Frequently asked questions