American Medical Association Family Medical Guide - American Medical Association [415]
Treatment
If you have had an ischemic stroke (caused by a blockage in an artery), your doctor may prescribe aspirin or other drugs that prevent blood clotting (anticoagulants). He or she may recommend that you take anticoagulant drugs for the rest of your life. If one of your carotid arteries is severely narrowed, your doctor may recommend a surgical procedure called carotid endarterectomy (see page 674) to clear plaque from the artery walls, improve blood flow to the brain, and reduce the risk of another stroke. He or she will also treat any abnormal heart rhythms (see page 580), which may be promoting the formation of blood clots. For some hemorrhagic strokes, doctors may perform surgery to clip an aneurysm, remove a clot or a blood vessel malformation, or relieve pressure on the brain. If you have high blood pressure, you will be given medication to lower it.
Rehabilitation After a Stroke or Other Brain Injury
For many people who have had a stroke or other brain injury, rehabilitation is essential for recovery. The goal of rehabilitation is to improve strength and coordination and help the person remain as independent as possible. The speed and extent of recovery from a stroke or brain injury vary from person to person, depending on factors such as the severity of the stroke and the person’s general health and attitude. The sooner rehabilitation begins, the more likely a person will recover some or all of the function in the impaired area and return to a productive life.
Rehabilitation usually begins in the hospital as soon as the person’s condition is stable. The therapy may continue in a hospital rehabilitation unit, a rehabilitation facility, or a skilled nursing facility. Rehabilitation may also be provided at an outpatient clinic or at home, with assistance from a home health care provider (such as a therapist) or caregivers (family members who have been trained by a nurse or therapist).
Aphasia
Aphasia is a speech disorder that usually results from damage (such as from a stroke) to the major language centers of the brain, but it is sometimes a symptom of a partial seizure, a migraine, or a mental disorder. The symptoms of aphasia include partial or total loss of the ability to speak or to understand words and, depending on the extent of brain damage, impairment of specific language functions. For example, a person who has aphasia may be unable to speak but may still be able to write, or may have trouble remembering particular categories of words such as names. Sometimes, although the person’s own speech is impaired, his or her comprehension of the speech of others remains unaffected. People who have aphasia are often able to repeat words they cannot recall on their own.
Aphasia differs from a speech disorder called dysarthria, which results from lack of control of the muscles of the lips, tongue, and face. Injection of dental anesthetics may sometimes produce temporary dysarthria, but the disorder can also result from injury to either the nerves or the area of the brain that controls the muscles used in speech. People who have dysarthria are able to understand what they hear, can read and write, and can correctly choose the words they want to speak, but their speech is unintelligible to others.
Aphasia is treated by diagnosing and treating the underlying cause of the disorder. When aphasia results from a stroke, recovery depends on the extent of the damage