Treatment

Treatments for stroke include medications, surgery, or rehabilitation. In the first few days after a stroke, treatment involves ensuring that the patient is well hydrated and nourished. The next phase of treatment - recovery through rehabilitation - involves a team of health professionals including physiotherapists, speech therapists, occupational therapists, nurses and doctors.

For most stroke patients, physical therapy is the cornerstone of the rehabilitation process. A physical therapist uses training, exercises, and physical manipulation of the stroke patient's body with the intent of restoring movement, balance, and coordination. The aim of physical therapy is to have the stroke patient relearn simple motor activities such as walking, sitting, standing, lying down, and the process of switching from one type of movement to another.

Another type of therapy involving relearning daily activities is occupational therapy (OT). OT also involves exercise and training to help the stroke patient relearn everyday activities such as eating, drinking and swallowing, dressing, bathing, cooking, reading and writing, and toileting. The goal of OT is to help the patient become independent or semi-independent.

Speech and language problems arise when brain damage occurs in the language centres of the brain. Due to the brain's great ability to learn and change (called brain plasticity), other areas can adapt to take over some of the lost functions. Speech therapy helps stroke patients relearn language and speaking skills, or learn other forms of communication. Speech therapy is appropriate for patients who have no deficits in cognition or thinking, but have problems understanding speech or written words, or problems forming speech. A speech therapist helps stroke patients help themselves by working to improve language skills, develop alternative ways of communicating, and develop coping skills to deal with the frustration of not being able to communicate fully. With time and patience, a stroke survivor should be able to regain some, and sometimes all, language and speaking abilities.

Many stroke patients require psychological or psychiatric help after a stroke. Psychological problems, such as depression, anxiety, frustration, and anger, are common post-stroke disabilities. Talk therapy, along with appropriate medication, can help alleviate some of the mental and emotional problems that result from stroke.

Sometimes surgery is needed. Carotid endarterectomy is an operation to remove plaque (a type of silting or "furring up" of the artery) from the main artery supplying the brain where this is shown to be narrowed by more than 70% of its usual diameter and where it has caused a stroke on the same side of the brain as the narrowing. There is a 1 - 3% risk that this operation will cause a stroke but a higher risk of a recurrent stroke if nothing is done.