In appropriate circumstances, other anti-coagulants such as heparin and coumadin are used to prevent recurrent strokes. Aspirin and other anti-platelet agents are used to prevent strokes as well.

Analgesics may be needed to control severe headache. Anti-hypertensive medication may be needed to control high blood pressure.

Nutrients and fluids may be neccesary, especially if the person has swallowing difficulties. The nutrients and fluids may given through an intravenous tube or a tube in the stomach (feeding tube or gastrostomy tube). Swallowing difficulties may be temporary or permanent.

Surgery may be appropriate in some cases, including surgical removal of blood clots from the brain.

Carotid endarterectomy, removal of plaque from the carotid arteries, may help prevent new strokes from occurring in some people.

LONG-TERM TREATMENT
The recovery time and need for long-term treatment vary. Depression and other symptoms should be treated.

Speech therapy, occupational therapy, physical therapy, positioning, range of motion exercises, and other therapies may prevent complications and promote maximum recovery of function. People should stay active within their physical limitations.

In some cases, urinary catheterization or bladder/bowel control programs may be necessary to control incontinence.

The individual's safety must be considered. Some people with stroke appear to have no awareness of their surroundings on the affected side. Others show a marked indifference or lack of judgment, which increases the need for safety precautions. For these people, friends and family members should repeatedly reinforce important cues, like name, age, date, time, and where they live, to help reduce disorientation.

Communication may require pictures, demonstration, verbal cues, or other strategies, depending on the type and extent of language deficit.

In-home care, boarding homes, adult day care, or convalescent homes may be required to provide a safe environment, control aggressive or agitated behavior, and meet physiological needs.

Behavior modification may be helpful for some people in controlling unacceptable or dangerous behaviors. This consists of rewarding appropriate or positive behaviors and ignoring inappropriate behaviors (within the bounds of safety).

Family counseling may help in coping with the changes required for home care. Visiting nurses or aides, volunteer services, homemakers, adult protective services, and other community resources may be helpful.

Legal advice may be appropriate. Advance directives, power of attorney, and other legal actions may make it easier to make ethical decisions regarding the care of the person with organic brain syndromes such as stroke.

Prognosis

Stroke is the third leading cause of death in developed countries. The outlook depends on the cause and extent of damage. Of those who survive a stroke, many have long-term disabilities, but some recover most or all function.

Complications

• Pressure sores
• Permanent loss of movement or sensation of a part of the body
• Bone fractures
• Joint contractures
• Muscle spasticity
• Permanent loss of cognitive or other brain functions
• Disruption of communication, decreased social interaction
• Decreased ability to function or care for self
• Decreased life span
• Multi-infarct dementia
• Side effects of medications
• Aspiration
• Malnutrition
• Pain syndromes (reflex sympathetic dystrophy)

Call Your Health Care Provider If:

Go to the emergency room or call the local emergency number (such as 911) if you have symptoms of a stroke. Stroke requires immediate treatment.

Ency. home > Disease > S > Stroke

---

[an error occurred while processing this directive]