Having a stroke can be a scary and life-changing event. Many people worry that having a stroke means they will be permanently disabled or have long-lasting effects. The good news is that it is possible to have a stroke without suffering permanent damage. While all strokes require prompt medical treatment, some strokes resolve without leading to lifelong impairments.
What is a stroke?
A stroke occurs when blood flow to part of the brain is interrupted, causing brain cells to die. There are two main types of stroke:
- Ischemic stroke – Occurs when a blood clot blocks an artery leading to the brain. This accounts for about 87% of all strokes.
- Hemorrhagic stroke – Caused by bleeding into the brain when a blood vessel ruptures. This accounts for about 13% of strokes.
When blood and oxygen can’t reach part of the brain, that section starts to die. The effects a person experiences depends on where in the brain the stroke occurred.
What are the effects of a stroke?
The brain controls everything we do, so a stroke can impact any area including:
- Movement
- Sensation
- Vision
- Speech and language
- Memory and thinking
- Swallowing
- Bowel and bladder function
The effects occur on the side of the body opposite the side of the brain where the stroke happened. For example, a stroke in the right side of the brain can cause deficits on the left side of the body.
Common impairments from a stroke include:
- Paralysis or weakness on one side of the body
- Trouble with balance and coordination
- Numbness or strange sensations
- Vision problems
- Trouble speaking, reading, or understanding language
- Cognitive issues like memory loss, confusion, and difficulty concentrating or making decisions
How much disability a person experiences depends on factors like:
- Where in the brain the stroke occurred
- How much of the brain was affected
- How quickly medical treatment was received
- The person’s age and overall health
- Quality of post-stroke rehabilitation
Can you fully recover from a stroke?
Many people wonder if it’s possible to fully recover from a stroke with no permanent effects. The answer is yes, it is possible to have a stroke and recover completely.
According to the National Stroke Association, about 10% of stroke survivors recover almost completely. However, even a “mild” stroke causes some brain injury. Patients may not notice any deficits but subtle effects on things like memory or processing speed may be detectable on testing.
People are most likely to make a full recovery when:
- The stroke was minor and only a small area of the brain was impacted.
- They receive treatment very quickly to restore blood flow.
- They are younger and in good general health.
- They participate actively in rehabilitation therapies.
Major factors that help determine if someone can fully recover include:
Size of the stroke
The smaller the stroke, the less brain tissue is impacted. Small strokes affect only limited areas, allowing function to return once the injury heals.
Location of the stroke
Strokes in “non-essential” areas are less likely to cause permanent deficits. The brain has redundancy and can sometimes recover lost abilities.
Time to treatment
Fast treatment restores blood flow and saves dying brain tissue. The phrase “time is brain” emphasizes that rapid treatment reduces brain injury.
Age and health
Younger people have greater reserves and brain plasticity, or ability to adapt. Good pre-stroke health also aids recovery.
Rehabilitation
Active participation in rehabilitation strengthens new neural pathways that take over lost abilities.
While full recovery is possible, most people have at least minor lingering effects. Intensive therapy and effort can help maximize abilities.
What deficits may remain after a minor stroke?
After a mild stroke, some common lasting deficits include:
- Fatigue – Extreme tiredness is very common after stroke.
- Memory loss – Difficulty learning and retaining new information.
- Attention – Decreased ability to concentrate and focus.
- Emotions – Mood changes like anxiety or depression.
- Vision – Problems with peripheral vision or trouble judging distances.
- Vertigo or dizziness – A feeling of the room spinning.
Minor stroke survivors may experience these deficits but be able to return to their normal activities. However, subtle cognitive deficits can make tasks like balancing a checkbook harder.
Can strokes lead to permanent disability?
While full recovery is possible after minor strokes, large strokes often cause permanent impairments. The greater the brain damage, the higher the chance of lasting disability.
According to the American Stroke Association, common permanent deficits include:
- Paralysis on one side of the body (hemiplegia)
- Speech difficulties (aphasia)
- Dementia
- Emotional problems
- Pain
- Numbness
- Vision loss
Major strokes can damage extensive areas in the brain that control movement, language, senses, and cognition. The larger the damaged area, the less likely the brain can recover.
People with permanent impairments require chronic care and assistance with activities of daily living. But rehabilitation therapy can still help them regain strength, mobility, and independence.
What are transient ischemic attacks (TIAs)?
Transient ischemic attacks (TIAs) produce stroke-like symptoms but no permanent damage. These “mini-strokes” are caused by a temporary blockage of blood flow to the brain that resolves on its own.
Common symptoms of a TIA include:
- Numbness or weakness in the face, arm, or leg, usually on one side
- Vision problems
- Slurred speech
- Dizziness or loss of balance
- Confusion
These symptoms typically last a few minutes up to 1-2 hours. Since TIAs resolve quickly, they do not cause lasting effects.
But TIAs are a major warning sign for stroke. About 1 in 3 people who have a TIA will go on to have a stroke soon after. TIAs indicate a partially blocked artery and high risk.
TIA treatment
Treatment for a TIA involves:
- Taking medications to reduce clotting and high blood pressure
- Undergoing carotid endarterectomy surgery if the TIA was caused by plaque buildup in neck arteries
- Making lifestyle changes like quitting smoking and exercising
The goal is to prevent a future stroke. When identified early, TIAs can serve as a critical warning sign to take action.
Can you have a “silent stroke”?
It is possible to have a silent stroke with no obvious symptoms. Silent strokes happen when a very small portion of brain tissue dies.
On MRI scans, silent strokes appear as tiny lesions in the brain. They are often first detected in patients getting brain scans for unrelated reasons.
Causes of silent strokes include:
- Chronic high blood pressure
- Atrial fibrillation
- Blood clots
- Fatty plaque buildup in arteries
The risks of silent strokes are:
- People who have silent strokes are at increased risk for future strokes.
- Over time, silent strokes can accumulate and lead to cognitive decline and dementia.
Patients with silent strokes require monitoring and early interventions to prevent further brain lesions.
How common are strokes in young adults?
While stroke risk increases with age, strokes do occur in younger people. An estimated 10% of strokes affect people under age 45.
Some key facts about stroke in younger adults:
- Stroke hospitalizations for those age 35-44 have risen over 30% in the past decade.
- High blood pressure, diabetes, high cholesterol, and smoking boost risk at younger ages.
- Illegal drug use such as cocaine and amphetamines increases stroke risk.
- Migraine with aura may increase risk in women under 45.
- Younger patients are more likely to make full recoveries than older patients.
All adults should know stroke warning signs and call 911 if they appear. Acting quickly leads to better outcomes at any age.
Can children have strokes?
Strokes do sometimes happen in infants and children, but they are less common in this age group. An estimated 3,000 children in the U.S. have strokes each year.
Types of stroke in children include:
- Ischemic stroke – A blood clot blocks blood flow to the brain. This accounts for about 50% of childhood strokes.
- Hemorrhagic stroke – Bleeding into the brain. Makes up 20% of strokes.
- Cerebral sinovenous thrombosis – A clot in the brain’s venous system. The cause of 20% of pediatric strokes.
Risk factors for childhood stroke include:
- Heart disorders that allow blood clots to form
- Sickle cell disease
- Head and neck infections
- Head trauma
- Genetic conditions that affect blood vessels
Effects of pediatric stroke depend on the child’s age and how much of the brain was damaged. Infants may show delays in reaching milestones. School-aged kids may struggle with disabilities.
With early therapy, young children can make excellent recoveries due to the brain’s natural plasticity.
Can you have a stroke while pregnant?
Stroke can occur during pregnancy and the postpartum period, but fortunately it is rare. An estimated 34 women per 100,000 deliveries experience a pregnancy-related stroke in the U.S.
Causes include:
- Preeclampsia – High blood pressure in pregnancy that causes bleeding or clotting.
- Eclampsia – Preeclampsia plus seizures.
- HELLP syndrome – A variant of preeclampsia that damages the liver.
- Blood clots – Increased clotting risks during pregnancy.
- Pregnancy complications like gestational diabetes and infections.
Symptoms of stroke during pregnancy include:
- Sudden numbness or weakness
- Confusion
- Trouble seeing
- Bad headache
- Trouble walking or losses of balance
Maternal stroke can be dangerous for both the woman and baby. Seeking immediate medical care is vital.
Can a head injury cause a stroke?
Yes, head trauma from events like car accidents and falls can sometimes lead to stroke. The stroke may happen right away or occur days or weeks later.
How head injury causes stroke:
- Blood vessel damage – If vessels tear, bleeding into the brain can compress tissue.
- Blood clots – Damage triggers clotting. Clots restrict blood flow.
- Brain swelling – Swelling raises pressure and reduces blood flow.
Those with head injuries require monitoring for signs like:
- Dilated or unequal pupils
- Slurred speech
- Confusion
- Sleepiness
- Numbness
- Seizures
Rapid stroke treatment can minimize brain damage in those with head trauma.
Can COVID-19 cause strokes?
Yes, a COVID-19 infection seems to put some patients at increased risk of stroke. Experts are still researching exactly how the coronavirus causes stroke.
Theories on why COVID raises stroke risk include:
- Severe inflammation may damage blood vessels.
- Abnormal blood clotting occurs in some patients.
- Low oxygen levels affect the brain.
Those hospitalized with severe COVID have the highest risk. But milder outpatient cases may also rarely trigger stroke.
Seek emergency care if you experience any sudden stroke symptoms, especially if you have COVID-19.
Conclusion
Strokes can range in severity from minor to catastrophic. The level of disability depends on the location and extent of brain tissue damage. It is possible to fully recover after a small stroke with limited effects.
Major strokes often cause impairment requiring extensive rehabilitation. But therapy can help patients regain function and live independently. Acting fast when stroke strikes is key – the quicker blood flow can be restored, the less permanent the damage will be.