Stroke

What Happens After a Stroke?logo

Once you’re admitted to SSM Health Saint Louis University Hospital, your physician will order diagnostic tests to evaluate your brain’s activity, specifically the extent of your injury and how the blood supply to your brain has been affected.

During your visit, you may undergo one or more of the following tests:

A CT scan (computed Tomography) is a key imaging test of the brain. This is usually one of the first tests given to a patient with stroke. This test provides valuable information about the cause of the stroke and the location and extent of the brain injury.

An MRI (Magnetic Resonance Imaging) also shows the location and extent of the injury, but has a much sharper and detailed picture. It is often used to diagnose small, more in-depth injuries.

Your brain controls how you move, feel, think and behave. Brain injury from a stroke may affect any one of these abilities. By identifying the affected area of the brain, your medical team will know what symptoms to expect and can plan your treatment accordingly.

Treatment

Nothing to eat or drink - Initially, we do not provide anything by mouth until a swallow reflex can be tested by the nurse. This is a simple test done with a small amount of water. Pneumonia is a major risk factor early in stroke as patients do not realize they are having swallowing difficulties. If the simple swallow test indicates a swallowing issue, we will prohibit any food by mouth, including oral medications. A speech therapist will then conduct a more comprehensive swallow assessment.

Blood Thinning Medication – If it is determined that the stroke was due to plaque or a blood clot in the arteries, the patient will be started on anticoagulation therapy. These are medicines that delay clotting of the blood, help prevent clots from forming and existing clots from enlarging. There is specific education about these medications that patients will receive from their caregivers – follow these directions closely.

Blood Pressure Control – This is the single most important risk factor for stroke and stroke reoccurrence. Nursing staff will monitor the patient’s blood pressure closely, and new medication may be started to help maintain desired blood pressure control.

Close monitoring is conducted to check for any new changes or a reoccurrence of symptoms.

Speech Therapy – This helps assess any swallowing disorders or language deficits caused by the brain injury.

Physical Therapy – This helps assess any physical deficits from the stroke. The medical provider can then develop a plan of care to maximize the patient’s mobility and independence for such activities as walking, balance and coordination.

Occupational Therapy – This helps assess any other deficits so the medical provider can develop a plan of care to maximize the patient’s return to independence.

Recovery

Following a stroke, a person will soon begin recovering his/her abilities. Some improvement occurs spontaneously as it relates to how the brain works again after it is injured. Many patients can benefit from a stroke rehabilitation program. These programs help improve abilities and teach compensation strategies and coping techniques.

Keep in mind that depression is not uncommon after a stroke, and can interfere with recovery. Therefore, it’s important to treat the symptoms associated with depression. Emotional ability or “reflex crying” can occur due to biological changes in the brain; these symptoms are different from depression. For instance, a person may cry or laugh, even though the reaction doesn’t match his/her mood. This may continue longer than expected.

The greatest improvement generally occurs within the first months after a stroke and will continue over the coming years with the patient’s effort.

Discharge & Rehabilitation

Fatigue is a common problem after stroke but generally resolves after a few months. The stroke survivor may have less energy due to difficulty sleeping, lack of exercise, poor nutrition or the side effects of medications. On the other hand, the stroke survivor may have the same amount of energy, but he/she may be using it differently. Some activities of daily living may take more effort. For instance, coping with frustration, anxiety, anger or sadness can cause fatigue.
The rehabilitation process for inpatient and outpatient primarily focuses on improving independence. Some key activities include:

  • Activities of daily living such as eating, bathing and dressing
  • Mobility skills such as transferring, walking or self-propelling a wheelchair
  • Communication skills in speech and language
  • Cognitive skills such as memory or problem solving
  • Socialization skills in interacting with other people
  • Psychological functioning to improve coping skills and treatment to overcome depression, if needed

Most stroke survivors are able to return home and resume many of the activities they were involved in before the stroke occurred.

For more information about the MidAmerica Stroke Network, call 866-676-4326.