Stroke - Consequences
Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
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The type and extent of the consequences of a stroke depend on the location and severity of the brain damage. Often there are sensory disorders, symptoms of paralysis, speech and language disorders. Visual disturbances are also frequent consequences of strokes. In some patients, personality also changes after a stroke. Find out more about the most important consequences of a stroke here!
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. I63I64I61I69
Stroke: Consequences That Change Life
About half of all patients who survive a stroke suffer permanent damage that changes their everyday life permanently. The type and extent of these consequences of a stroke depend on which brain area was damaged and how severely. Very often those affected are in need of care or even severely disabled due to the consequences of a stroke.In Germany, stroke is the single most common cause of need for care.
Consequences of a stroke: movement disorders
After a stroke, many sufferers have movement disorders (motor deficits). The spectrum ranges from slight gait insecurities to extensive paralysis. For example, incomplete hemiplegia (hemiparesis) very often occurs: It affects not only the arm and leg, but also the face. One-sided facial paralysis can be recognized by a drooping corner of the mouth and sagging eyelid. Speaking, chewing, and swallowing can also be affected by the paralysis.
Other common consequences of strokes are ataxia and apraxia: The term ataxia describes impaired coordination of movements. This can affect both gross motor skills (e.g. walking) and fine motor skills (e.g. writing).
In apraxia, the execution of more complex movements such as combing hair or opening letters is disturbed. The motor skills required for this or the individual movements (such as raising the arm to head height), on the other hand, are not impaired. Apraxia often occurs when the left hemisphere is damaged.
Stroke consequences: neglect and other attention deficit disorders
Stroke patients with a neglect behave as if one side of the outside space (including their own body) was absent. Usually it is the left side (due to damage to the right hemisphere). Things in the affected half of the room are neglected, i.e. simply ignored, as if they did not exist. The sensory stimuli are received by the body, but not consciously perceived. The patients themselves usually do not even notice this.
Spatial attention is disturbed in neglect. But there are other forms of attention disorder that can result from a stroke. For example, some patients have problems with selective attention: they cannot concentrate or can hardly concentrate on one thing and switch off irrelevant stimuli accordingly. After a stroke, vigilance (sustained attention), i.e. the ability to maintain one's own attention for a longer period of time, can also be impaired.
Consequences of a stroke: speech and speech disorders
Speech communication can be impaired in different ways after a stroke. Even a slight stroke can have consequences in the speech area, more precisely a slight aphasia: With this speech disorder, patients can only make their thoughts difficult to understand or they can hardly understand what others are saying to them. This also affects reading and writing.
Speech disorders are also possible consequences of a stroke: those affected speak choppy, slurred, monotonous and slow or rash.
Consequences of a stroke: difficulty swallowing
Widespread consequences of a stroke are swallowing disorders (dysphagia). With hemiplegic facial paralysis, for example, patients have problems keeping fluids in their mouths or shaping the food into a ball that is easy to swallow.
A disturbed swallowing reflex caused by damage to the brain stem can be more fatal: Normally, when swallowing, the vocal folds close reflexively and the epiglottis closes the trachea. If this reflex is disturbed, food can get into the windpipe. This can cause severe coughing attacks or even attacks of suffocation. In addition, food particles that get into the lungs can cause pneumonia (aspiration pneumonia).
Such aspiration pneumonia can also develop if the coughing stimulus is switched off due to the damage to the brain. Then swallowed food residues cannot be transported outwards by coughing. Doctors speak of "silent aspiration".
Swallowing disorders after a stroke are often followed by malnutrition, malnutrition and lack of fluids: swallowing can be so difficult that the patient does not consume enough food and fluids.
Consequences of a stroke: visual disturbances
A stroke is very often followed by visual disturbances. What type they are depends on which part of the visual pathway (optic nerve, visual centers in the brain) is affected by the brain damage.
For example, many patients have a narrowed field of vision: the edge zones are darkened, as if the patient were looking through a tube or tunnel (tunnel vision). Sometimes half the visual field is missing in both eyes (hemianopia). The visual field loss can also affect a smaller part of the field of view, such as only a quarter (quadrant anopia) or any smaller part (scotoma).
If the stroke has damaged the so-called secondary visual center in the brain, the patients can see their surroundings, but can no longer recognize or name them. Other possible consequences of a stroke in the visual area are, for example, double vision, flickering and short-term blindness in one eye.
Consequences of a stroke: sensory disturbances
After a stroke, many people affected can only perceive sensory perception to a limited extent or not at all in individual areas of one half of the body. For example, the patients hardly or not at all feel touch, pain and temperature stimuli in the respective body region.
Consequences of a stroke: impaired memory
Memory disorders are also one of the common consequences of strokes. For example, some patients have problems retrieving stored knowledge that was acquired before the stroke. Others find it difficult to remember new information. However, this can also be due to an attention disorder.
The type of memory impairment often suggests the location of the brain damage. For example, if a stroke patient can no longer remember factual knowledge (such as the capital of Great Britain, professional knowledge or cooking recipes), the stroke has impaired the so-called semantic memory in the left temporal lobe. Damage to the right frontal lobe, on the other hand, can affect episodic memory. This is the seat of personal experiences like your own wedding.
Consequences of a stroke: personality changes
The patient's personality can change as a result of a stroke. Some become listless or show signs of resignation and depression. Others are prone to compulsive crying or sudden outbursts of anger. This requires a lot of understanding and patience on the part of the relatives and caregivers.
Other consequences of a stroke
A stroke is often followed by other disorders and impairments. For example, an infarction in the brainstem can, in addition to the aforementioned visual disturbances and facial paralysis, also change the sense of taste or cause a hearing impairment. Some patients also suffer from stool or urinary incontinence. Other common consequences of stroke are balance disorders and dizziness. They are based on damage to the cerebellum or brain stem and increase the risk of falling.
Stroke sequelae: prognosis
Whether and to what extent the consequences of a stroke improve on their own or through therapy varies greatly. The fact that movement disorders and some other effects of a stroke are even possible is due to the plasticity of the brain: By reorganizing nerve connections, other areas of the brain can often take over the tasks of the damaged brain region.
In general, the prognosis of the consequences of a stroke depends on many different factors. These include the age of the patient, the severity of the damage and the type of therapy. This should be tailored to the individual needs and deficits of the patient.
Movement disorders, for example, which are one of the most common consequences of a stroke, rarely go away completely. In most cases, however, they improve within eight to twelve weeks of the stroke. However, there are also patients for whom regression takes months or years.
In stroke patients with many small vascular occlusions in the brain (lacunar infarcts), purely motor failures and intact body awareness, the chances of success of a therapy are usually good. This also applies if there is severe hemiplegia in the acute phase after the attack. The prognosis is worse if there are additional neurological consequences of a stroke, for example if the patient also has aphasia (speech disorder) or a neglect.
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