SECTION 1 The brain and stroke

How the brain works Understanding stroke Stroke risk factors Effects of stroke Stroke recovery 2

Brain functions Movement – motor functions and the coordination of movement Perception – how we interpret information from our senses Sensation – such as touch Vision – how we see Cognition – thinking, remembering, understanding, planning, reasoning and problem-solving Communication – speaking and understanding Personality – including emotions and behaviour

The two sides of the brain control different functions 4

The brain needs oxygen and nutrients 5

Types of stroke 6

Understanding stroke Stroke A sudden injury to part of the brain caused when blood flow in an artery stops. The affected area of the brain is deprived of oxygen and nutrients. This damages the neurons and the functions they control. Neurons that die cannot be replaced or restored.

Understanding TIA TIA Transient Ischemic Attack (TIA) When an artery has only a temporary blockage, it is called a transient ischemic attack (TIA) or warning stroke. The symptoms last only a few minutes to an hour. It is not sure if TIA leaves permanent brain damage, but the symptoms should never be ignored as there is a chance for the person to have another, more damaging stroke.

5 warning signs of stroke Weakness - Sudden loss of strength or sudden numbness in the face, arm or leg, even if temporary. Trouble speaking - Sudden difficulty speaking or understanding or sudden confusion, even if temporary. Vision problems - Sudden trouble with vision, even if temporary. Headache - Sudden severe and unusual headache. Dizziness - Sudden loss of balance, especially with any of the above signs. 9

Key point Stroke quickly damages or kills neurons in the brain. Recognize the signs early and call 911 or your local emergency number. Without fast treatment, the chance of reducing stroke damage decreases fast. 10

Risk factors for stroke There are two kinds of risk factors: Modifiable risk factors can be controlled by lifestyle changes, medical treatment, and medications. Non-modifiable risk factors, such as age, cannot be changed. 11

Modifiable risk factors Hypertension (high blood pressure) Hypercholesterolemia (high blood cholesterol) Atrial fibrillation (irregular heart beat) Diabetes Smoking Being overweight or obese Physical inactivity Excessive alcohol consumption Stress (not managing stress)

Non-modifiable risk factors Age (while strokes can occur at any age, most occur over age 65) Gender (women have a lower risk before menopause than men. But more women than men die of stroke) Ethnicity (increased risk for persons of Aboriginal, African or South Asian descent because of higher rates of high blood pressure and diabetes) Family history (if a parent or sibling had a stroke before age 65) Prior stroke or TIA

Key point Having a stroke or TIA increases the risk of another stroke. The risk is greatest immediately after the stroke or TIA and stays high for 5 years. Overall, 30% of stroke survivors have a second stroke. 14

Lowering stroke risk Stroke survivors can reduce their risk of another stroke by controlling modifiable risk factors. Working to control just one stroke risk factor can reduce the risk of stroke. Setting realistic goals together helps motivate stroke survivors to keep trying. 15

Effects of stroke The effects of a stroke depend on many things: The region of the brain that was affected The size of the area that was damaged by the stroke The functions that the area controlled 16

Common effects of stroke Paralysis or weakness on one side of the body Vision problems Communication problems Fatigue Incontinence (loss of bladder control) Changes in how a person perceives or interprets the world Personality changes Depression or loss of emotional control Ability to remember, solve problems, and communicate with others

Stroke recovery depends on: The type and severity of the stroke Age and health Family support Personal outlook Availability of rehab services 18

Key point What is the difference between impairment and disability? Impairment is the change in function caused by the stroke. Disability is the change in ability to meet daily demands or do things because of an impairment. Disability can be extremely frustrating for the survivor. 19

You can help stroke survivors to: Relearn routine activities of living Regain abilities so they can go back to living like they used to Cope with challenges and frustrations Do things they can’t do for themselves yet. You can also support and educate family members. 20

Upon reflection Would you be able to recognize the signs of a stroke? Are you at risk for a stroke? 21