Stroke Recovery: Living A Long Life After

A stroke is a life-altering event that can have severe and long-lasting effects on a person's life. It is a leading cause of death and disability worldwide, with the global incidence increasing by 25% in the past decade. While strokes can cause permanent brain damage and long-term disability, the prognosis for stroke survivors varies significantly. The recovery process can be lengthy and challenging, but it is possible to make a full recovery and live a long life after a stroke.

Several factors influence the chances of survival and the quality of life after a stroke. These include the person's age, the type of stroke, the severity of the stroke, the time to treatment, and the person's overall health. Younger people tend to have a better outlook, and those who receive treatment within three hours of symptom onset have an increased chance of recovery. The type and severity of the stroke also play a crucial role, with ischemic strokes generally associated with a more positive outlook than hemorrhagic strokes.

The physical, social, and psychological consequences of a stroke can be devastating, and they dramatically change a person's life. About 90% of ischemic stroke survivors have some form of disability, and life expectancy after a stroke is reduced by approximately five to seven years. However, this does not mean that a long life is impossible. With proper care, rehabilitation, and support, many stroke survivors can improve their quality of life and live for many years.

The recovery process may involve working with different specialists, such as speech therapists, physical therapists, and occupational therapists, to address the various challenges that arise after a stroke. Additionally, mental health support is crucial, as many stroke survivors struggle with depression, anxiety, and other emotional issues.

While a stroke can have a significant impact on life expectancy, the individual variation is crucial to consider. Each case is unique, and the recovery process depends on various factors, including the severity of the stroke, the quality of treatment, and the individual's physiological characteristics. Seeking medical care as soon as possible and following a rehabilitation plan can improve the chances of a full recovery.

Life expectancy after a stroke

Several factors influence life expectancy after a stroke. These include age, type of stroke, and time to treatment. Younger people tend to have a better outlook than older adults. Ischemic strokes are typically associated with a more positive outlook than hemorrhagic strokes. Receiving treatment within 3 hours of the start of ischemic stroke symptoms can increase your chances of recovery.

According to a 2022 study, having any type of stroke was associated with a 5.5-year reduction in life expectancy. The reduction in life expectancy was even higher for hemorrhagic strokes, with people losing on average 7.4 years.

Another study found that adults under 50 have an increased risk of death for at least 15 years after a stroke. This is based on a 2019 Dutch study that examined long-term outcomes in people aged 18-49 who survived at least 30 days after their first stroke.

It's important to note that these findings are based on averages, and individual outcomes can vary significantly. Additionally, advancements in medical technology and treatments can also impact life expectancy after a stroke.

While a stroke can reduce life expectancy, it is possible to make a full recovery and live for many years afterward. Rehabilitation and adopting a healthy lifestyle can help improve your quality of life and potentially increase your life expectancy.

Factors that influence recovery

Age

Age is a significant factor in long-term survival after a stroke. People aged 85 and older have the highest death rate: the risk of dying is 13 times higher than for people aged 65 to 74. The risk of dying is three times higher for people aged 75 to 84 compared to people aged 65 to 74. Younger people tend to have a better outlook than older adults.

Type of stroke

The type of stroke also plays a role in life expectancy and recovery after a stroke. Ischemic strokes are typically associated with a more positive outlook than hemorrhagic strokes. Transient ischemic attacks (TIAs) or "ministrokes" are not life-threatening and lead to a full short-term recovery. However, they are a sign of potentially significant health problems that put a person at a much higher risk of having a major stroke in the future.

Stroke location

Strokes that affect the brain stem are associated with more severe complications.

Stroke severity

Having a large stroke that affects many areas of the brain can result in more significant disability or death than a stroke that affects a small area of the brain. The severity of a stroke is measured by analyzing neurological abnormalities and examining the brain with a CT or MRI scan.

Time to treatment

People who receive treatment within 3 hours of the start of ischemic stroke symptoms have an increased chance of recovery.

Overall health

People with cerebrovascular disease and heart disease were most likely to die within three years of a first-time stroke. The chances of preventing another stroke are improved by treating the underlying cause of the stroke, including high blood pressure, high cholesterol, diabetes, and more.

Social support system

People with strong social support networks might be more likely to return to their former activities after a stroke.

Types of stroke

There are two main types of stroke: ischemic strokes and hemorrhagic strokes. These are based on what causes the interruption of blood flow to the brain.

Ischemic Strokes

Ischemic strokes are the most common type of stroke, accounting for about 87% of all stroke cases. They occur when there is a blockage in a blood vessel supplying blood to the brain, usually due to a blood clot or a buildup of plaque. Ischemic strokes can be further divided into two categories:

• Thrombotic strokes: caused by a blood clot that develops in the blood vessels inside the brain.
• Embolic strokes: caused by a blood clot or plaque debris that develops elsewhere in the body and travels to one of the blood vessels in the brain through the bloodstream.

Hemorrhagic Strokes

Hemorrhagic strokes are less common but tend to be more severe and progress more quickly. They occur when a weakened blood vessel supplying the brain ruptures and bleeds. This can be caused by aneurysms or arteriovenous malformations (AVMs). Hemorrhagic strokes can also be divided into two subtypes:

• Intraparenchymal hemorrhages: bleeding occurs directly in the brain tissue, often due to high blood pressure.
• Subarachnoid hemorrhages: bleeding occurs in the subarachnoid space, between the brain and the surrounding membrane. This is often due to an aneurysm or AVM.

Transient Ischemic Attack (TIA)

Transient Ischemic Attack (TIA) is often referred to as a "mini stroke" or "warning stroke". It is caused by a temporary clot and usually lasts only a few minutes to an hour. While TIA symptoms may go away quickly, it should be taken seriously as it is often a warning sign of a more severe stroke in the future.

Cryptogenic Stroke

A cryptogenic stroke is a term used when the cause of the stroke cannot be determined.

Brainstem Stroke

A brainstem stroke refers to the location of the stroke, which is the brainstem, rather than the cause. The brainstem controls essential functions like breathing, heartbeat, and consciousness, so damage to this area can result in severe consequences such as coma and locked-in syndrome.

Stroke symptoms

Strokes are the fifth leading cause of death in the United States and a leading cause of long-term disability. They can cause permanent brain damage and long-term disability and may reduce your life expectancy. It is an emergency situation, and the faster you receive treatment, the better.

The three main types of strokes are:

• Ischemic stroke: The most common type of stroke, ischemic strokes result from a clot that prevents oxygen-rich blood from flowing into the brain.
• Hemorrhagic stroke: This type of stroke is due to blood vessels bleeding or rupturing. The bleeding puts pressure on brain cells and leads to brain cell death.
• Transient ischemic attack (TIA): Known as a ministroke, these differ from the other two strokes because symptoms usually last for only a few minutes to an hour.

Signs and Symptoms

• A severe headache that occurs out of the blue
• Numbness and/or weakness of the legs, arms, and/or face (particularly on one side)
• Vision issues in one or both eyes
• Confusion, difficulty understanding speech, and trouble speaking
• Difficulty walking, sudden incoordination, or loss of balance

Call emergency services immediately if you notice any of the following "FAST" signs of a stroke:

• F = Face drooping, including numbness and one-sided drooping
• A = Arm weakness, including weakness and numbness, especially on one side
• S = Speech slurring or difficulty
• T = Time to call emergency services fast and let the dispatcher know the time that symptoms began

Post-stroke rehabilitation

Rehabilitation services are provided in various settings, including acute care and rehabilitation hospitals, long-term care facilities, outpatient facilities, and even at home through health agencies. The intensity and type of rehabilitation depend on factors such as the patient's ability to tolerate the intensity, the degree of disability, and geographical location.

The rehabilitation team consists of doctors, such as neurologists and physiatrists, occupational therapists, speech and language pathologists, registered dietitians, social workers, chaplains, and psychologists, among others. These professionals address the five main types of disabilities that a stroke can cause:

• Paralysis or problems with movement, balance, or swallowing.
• Sensory disturbances, including issues with touch, pain, temperature, or position.
• Language comprehension and expression difficulties.
• Thinking and memory problems.
• Emotional disturbances.

Rehabilitation therapy is designed to help patients re-learn skills like self-care (feeding, grooming, bathing, etc.), mobility (walking, transferring, etc.), speech and communication, cognitive abilities (memory, problem-solving, etc.), and social interaction. Additionally, psychological support is provided to help patients cope with emotional issues and adjust to lifestyle changes.

The rehabilitation process ideally begins as soon as possible after the stroke, sometimes even the next day, if the patient is medically stable. It is recommended for all stroke survivors as it improves recovery outcomes.

Frequently asked questions