Scar Tissue: Can It Cause A Stroke?

Scar tissue is a natural part of the body's healing process after an injury, but it can sometimes cause issues. Excess scar tissue can reduce function and movement, particularly around the joints. While scar tissue can develop anywhere in the body, it is most common in large muscle groups and around the heart. In the case of heart scar tissue, or atrial fibrosis, excessive buildup can lead to abnormal heart rhythms and an increased risk of stroke, heart attack, heart failure, and cardiovascular death. However, it is important to note that not all scar tissue will lead to these issues, and there are treatments available to help manage and minimize scarring.

Excess scar tissue can reduce function and movement

Excess scar tissue can significantly reduce function and movement. Scar tissue is the body's natural response to an injury, and it is made of collagen, a protein that acts as a building block for many tissues and structures in the body. However, scar tissue lacks the flexibility and elasticity of normal, healthy tissue. It is thicker and less flexible than regular tissue, which can restrict movement.

Scar tissue can develop anywhere in the body, but it is most common in large muscle groups such as hamstrings, quads, and calves. It can also frequently form around joints, causing a reduced range of motion, stiffness, and discomfort. For example, frozen shoulder, which sometimes follows surgery, is caused by a buildup of scar tissue around the shoulder joint, leading to pain and reduced mobility.

Hypertrophic scars, which are thick, raised scars, can also limit movement, especially if they form over a joint. These scars are an abnormal response to wound healing, where extra connective tissue forms within the original wound area. While these scars are mainly a cosmetic issue, they can cause pain, itching, and restricted movement, which may prompt individuals to seek treatment.

To improve function and movement affected by excess scar tissue, various treatments are available, including exercise, massage, and therapeutic interventions. Early movement after surgery can also help prevent excess scar tissue formation and improve outcomes.

Hypertrophic scars are thicker and less flexible than normal tissue

The collagen in hypertrophic scars is thicker than the rest of the skin, and this thicker, less flexible tissue becomes a scar. This scar tissue lacks the flexibility and elasticity of normal, healthy tissue. The random layering of scar tissue, usually in a criss-cross pattern, results in a tough, fibrous tissue that restricts movement. This is especially true if the scar forms over a joint.

Hypertrophic scars are more common in taut skin areas, such as the back, chest, shoulders, upper arms, and other joints. They are often red to brown in colour and may be itchy or painful. They generally develop after thermal or traumatic injury involving the deep layers of the dermis.

Treatments for hypertrophic scars include medication, freezing, injections, lasers, and surgery. Early hypertrophic scars should be treated with applied pressure and massage, and silicone therapy can be applied later. Ongoing hypertrophy may be treated with corticosteroid injections.

Heart scar tissue can increase the risk of stroke

Excessive scar tissue can be detrimental to the body, especially when it comes to the heart. Scar tissue in the heart, also known as atrial fibrosis, can develop in the chambers of the heart and lead to abnormal heart rhythms and strokes. The presence of scar tissue in the heart can increase the risk of major adverse cardiovascular and cerebrovascular events, including stroke, heart attack, heart failure, and even cardiovascular death.

The University of Utah Health researchers conducted a study that examined the relationship between left atrial fibrosis and the risk of cardiovascular events in patients with atrial fibrillation. The study found that patients with more advanced left atrial fibrosis were more likely to experience adverse cardiovascular events, particularly strokes. This provides evidence that examining heart tissue can help predict the risk of stroke.

The formation of scar tissue after a heart attack is the body's natural repair mechanism. However, some individuals develop much larger scars than others, and these extensive scars can have negative consequences. Larger scars in the heart can reduce the heart's ability to pump blood effectively, putting additional strain on the heart muscle. This can lead to heart rhythm problems, heart failure, and even sudden cardiac death.

The size of the scar tissue formed after a heart attack is influenced by a protein called type 5 collagen. In a study conducted by Dr. Arjun Deb and his team, they found that mice deficient in type 5 collagen formed larger and more abnormal scars after a heart attack, resulting in worse heart function. The collagen fibers in the scar tissue of these mice were disorganized, leading to a more flexible scar that could expand due to the force of the blood within the heart. This expansion can disrupt the normal beating of the heart.

The relationship between scar tissue and the risk of stroke is a serious concern, especially for individuals with heart conditions. Further research and long-term studies are being conducted to better understand the progression of left atrial fibrosis and to develop interventions to stop or reverse its development, reducing the risk of cardiovascular events, including strokes.

Keloids are larger, puffy-looking scars that grow beyond the wound area

Keloids are a type of scar that can form after skin injuries from cuts, surgery, trauma, or piercing. They are characterised by the growth of excess scar tissue beyond the original wound area. Keloids are larger and puffier than typical scars, and they can be flesh-coloured, red, or pink.

Keloids are the result of an abnormal response to wound healing, where extra connective tissue forms and extends beyond the boundaries of the initial injury. This process can take months or even years, and it can cause the scar to become very large. While keloids are typically not harmful to one's health, they can be a cosmetic concern and may affect mobility if they develop over a joint.

The formation of keloids is influenced by genetic factors and is more common in certain ethnic groups, such as Black, Asian, and Hispanic individuals. Additionally, keloids are more prevalent in people under 30 years of age.

Keloids can be uncomfortable, itchy, or painful, and they may require treatment to reduce their size and improve symptoms. Treatment options include corticosteroid injections, cryotherapy (freezing), silicone gel or patches, and surgery. However, it is important to note that keloids have a high recurrence rate, and even treatments like surgery may not provide a permanent solution.

Treatments for scar tissue include exercise, massage, medication, and surgery

Scar tissue is a natural part of the body's healing process, but it can sometimes cause issues. The tissue lacks the flexibility and elasticity of normal, healthy tissue, and can restrict movement, especially around joints.

There are a variety of treatments for scar tissue, including exercise, massage, medication, and surgery.

Exercise and Massage

Physical therapy is often used to treat scar tissue, with the standard treatment involving stretching and pulling the scar tissue to soften, align and elongate it. This can help to improve the range of motion, strength, and mobility of the affected area. Manual stretch therapy and joint mobility exercises are usually started soon after surgery, but can still be beneficial years later.

Medication

Doctors can prescribe medication to reduce the appearance of scarring and address the psychological impact and physical restrictions a scar can cause. Corticosteroid injections are the first choice for treating keloids and the second choice for hypertrophic scars. These injections are made into the scar tissue to flatten and soften it, as well as ease pain and itching. Several injections may be needed, given a few weeks apart.

Surgery

In severe cases, or those that affect a person's livelihood, surgery can be performed to remove scar tissue. However, surgery is not recommended unless it is absolutely necessary, as it can result in further scarring.

Frequently asked questions