After a stroke, you probably have a lot of questions and concerns about how -- and even if -- you will recover. When will you be able to move your arms? Is your independent life gone forever?
It's difficult to predict to what degree someone will recover after a stroke, says Randie M. Black-Schaffer, MD. Schaffer is medical director of the Stroke Program at Spaulding Rehabilitation Hospital in Boston. "How quickly a patient recovers in the first few weeks," she says, "can give us an indication of how much damage occurred, and we can make some educated guesses based on that."
Thrombolysis, also known as thrombolytic therapy, is a treatment to dissolve dangerous clots in blood vessels, improve blood flow, and prevent damage to tissues and organs. Thrombolysis may involve the injection of clot-busting drugs through an intravenous (IV) line or through a long catheter that delivers drugs directly to the site of the blockage. It also may involve the use of a long catheter with a mechanical device attached to the tip that either removes the clot or physically breaks it up.
According to the National Institute of Neurological Disorders and Stroke, how well you recover depends upon the type of stroke you had, how much brain damage occurred from the stroke, your age, and how quickly rehabilitation begins.
Black-Schaffer advises learning all you can about what caused your stroke and what you can do to avoid further health problems. Use the following questions as a guide when you talk with your doctor about what to expect in the months and years ahead.
1. What caused my stroke?
Eighty percent of all strokes occur when blood flow to the brain is suddenly cut off -- usually by a blood clot or some other obstruction. This is called an ischemic stroke. A hemorrhagic stroke occurs when a blood vessel ruptures in the brain.
Knowing the type of stroke you had can help your doctor determine the underlying cause. For example, an ischemic stroke may be caused by a blocked artery due to the buildup of plaque -- a mixture of cholesterol and other lipids, or blood fats. People with atherosclerosis, or hardening of the arteries from plaque buildup, are more at risk for this type of stroke. High blood pressure is a common culprit in hemorrhagic stroke. Both of these conditions increase the risk of stroke, and managing them can help prevent a second stroke.
2. Am I at risk for a second stroke?
The overall risk of a second stroke is highest right after a stroke. Three percent of survivors have a second stroke in the first 30 days, and one-third will have another within two years.
"However, individual risk factors are highly variable," Black-Schaffer says. "That's why it's vital to talk with your doctor to understand your specific risk factors and develop a plan to minimize them."
High blood pressure is the number one cause of stroke and the biggest risk factor for stroke. Having heart disease, high blood cholesterol, or diabetes also puts you at risk. Lifestyle factors that put you at risk include smoking cigarettes, obesity, physical inactivity, heavy alcohol consumption, and illicit drug use.
3. What is the stroke recovery process?
Although your stroke rehabilitation program will be tailored to your specific needs, most people follow a similar path. You'll begin to do assisted exercises in the hospital once your medical condition has stabilized.