Stroke Awareness Foundation

You may be eligible for a clinical trial that could improve motor function and cognitive status in those who have had strokes! If you are interested in learning more about this FDA-approved clinical trial, please contact the site nearest you, either in Palo Alto, CA or Pittsburgh, PA by visiting www.clinicaltrials.gov or www.san-bio.com.

http://www.strokeclinicaltrial .org/

www.strokeclinicaltrial.org

A new clinical trial is testing SB623, an adult stem cell therapy that has been successfully evaluated in preclinical models of stroke. In this clinical study, safety as well as efficacy parameters will be evaluated, such as improvements in motor function and cognitive status.

People with PBA are unable to control their emotional expressions the way they used to. When this happens in social settings, they feel embarrassed, frustrated and angry. They also sense that others are uneasy. They may avoid work, public places and family get-togethers. This can lead to feelings of fear, shame and isolation.

There is no treatment approved by the Federal Drug Administration (FDA) for PBA, though antidepressant drugs can help.

These things may help you cope with PBA:

• Be open about it. Warn people that you cannot always control your emotions. Explain that the emotions you show on the outside don’t always reflect how you feel on the inside.

• Distract yourself. If you feel an outburst coming on, focus on something boring or unrelated. Try counting the number of items on a shelf.

• Note the posture you take when crying. When you think you are about to cry, change your posture.

• Breathe in and out slowly until you are in control.

• Relax your forehead, shoulders and other muscles that tense up when crying.

Our answer:  Use F.A.S.T. (face, arms, speech, time) FAST does not cover every possible symptom of stroke. However, it is easy to remember and it is estimated that about 8 or 9 in 10 people with a stroke will have one or more FAST symptoms.

FACE – Ask the person to smile. Does one side of the face droop?

ARMS – Ask the person to raise both arms. Does one arm drift downward? 

SPEECH– Ask the person to repeat a simple sentence. Are the words slurred? Can the person repeat the sentence correctly? 

TIME – If the person shows any symptoms, time is important. Call 9-1-1 immediately

Rehabilitation helps stroke survivors relearn skills that are lost when part of the brain is damaged. For example, these skills can include coordinating leg movements in order to walk or carrying out the steps involved in any complex activity. Rehabilitation also teaches survivors new ways of performing tasks to circumvent or compensate for any residual disabilities. Individuals may need to learn how to bathe and dress using only one hand, or how to communicate effectively when their ability to use language has been compromised. There is a strong consensus among rehabilitation experts that the most important element in any rehabilitation program is carefully directed, well-focused, repetitive practice—the same kind of practice used by all people when they learn a new skill, such as playing the piano or pitching a baseball.

Rehabilitation should begin as soon as a stroke patient is stable, sometimes within 24 to 48 hours after a stroke. This first stage of rehabilitation can occur within an acute-care hospital; however, it is very dependent on the unique circumstances of the individual patient. Post-stroke rehabilitation involves physicians; rehabilitation nurses; physical, occupational, recreational, speech-language, and vocational therapists; and mental health professionals.

Physicians have the primary responsibility for managing and coordinating the long-term care of stroke survivors, including recommending which rehabilitation programs will best address individual needs. Physicians also are responsible for caring for the stroke survivor’s general health and providing guidance aimed at preventing a second stroke, such as controlling high blood pressure or diabetes and eliminating risk factors such as cigarette smoking, excessive weight, a high-cholesterol diet, and high alcohol consumption.

Nurses specializing in rehabilitation help survivors relearn how to carry out the basic activities of daily living. They also educate survivors about routine health care, such as how to follow a medication schedule, how to care for the skin, how to move out of a bed and into a wheelchair, and special needs for people with diabetes. Rehabilitation nurses also work with survivors to reduce risk factors that may lead to a second stroke, and provide training for caregivers. Nurses are closely involved in helping stroke survivors manage personal care issues, such as bathing and controlling incontinence. Most stroke survivors regain their ability to maintain continence, often with the help of strategies learned during rehabilitation. These strategies include strengthening pelvic muscles through special exercises and following a timed voiding schedule. If problems with incontinence continue, nurses can help caregivers learn to insert and manage catheters and to take special hygienic measures to prevent other incontinence-related health problems from developing.

Physical therapists specialize in treating disabilities related to motor and sensory impairments. They are trained in all aspects of anatomy and physiology related to normal function, with an emphasis on movement. They assess the stroke survivor’s strength, endurance, range of motion, gait abnormalities, and sensory deficits to design individualized rehabilitation programs aimed at regaining control over motor functions. Physical therapists help survivors regain the use of stroke-impaired limbs, teach compensatory strategies to reduce the effect of remaining deficits, and establish ongoing exercise programs to help people retain their newly learned skills. Disabled people tend to avoid using impaired limbs, a behavior called learned non-use. However, the repetitive use of impaired limbs helps reduce disabilities. Strategies used by physical therapists to encourage the use of impaired limbs include selective sensory stimulation such as tapping or stroking, active and passive range-of-motion exercises, and temporary restraint of healthy limbs while practicing motor tasks. In general, physical therapy emphasizes practicing isolated movements, repeatedly changing from one kind of movement to another, and rehearsing complex movements that require a great deal of coordination and balance, such as walking up or down stairs or moving safely between obstacles. People too weak to bear their own weight can still practice repetitive movements during hydrotherapy (in which water provides sensory stimulation as well as weight support) or while being partially supported by a harness. A recent trend in physical therapy emphasizes the effectiveness of engaging in goal-directed activities, such as playing games, to promote coordination. Physical therapists frequently employ selective sensory stimulation to encourage use of impaired limbs and to help survivors with neglect regain awareness of stimuli on the neglected side of the body.

Like physical therapists, occupational therapists are concerned with improving motor and sensory abilities, and ensuring patient safety in the post-stroke period. They help survivors relearn skills needed for performing self-directed activities (also called occupations) such as personal grooming, preparing meals, and housecleaning. Therapists can teach some survivors how to adapt to driving and provide on-road training. They often teach people to divide a complex activity into its component parts, practice each part, and then perform the whole sequence of actions. This strategy can improve coordination and may help people with apraxia relearn how to carry out planned actions. Occupational therapists also help people make changes in their homes to increase safety, remove barriers, and facilitate physical functioning, such as installing grab bars in bathrooms.

Speech-language pathologists help stroke survivors with aphasia relearn how to use language or develop alternative means of communication. They also help people improve their ability to swallow, and they work with patients to develop problem-solving and social skills needed to cope with the after-effects of a stroke.

Talk to your healthcare provider about possible options that are right for you. Repetition of you or your loved one’s therapy is key to a higher quality of life!

Three common problems are aphasia, dysarthria and apraxia. Your loved one may have one or more of these problems at the same time.

-Aphasia is a problem with using and/or understanding language. Aphasia is caused by damage to part of the brain. People with aphasia have a hard time finding the “right” words. They may not be able to say the words they want or the words come out wrong. People with aphasia may have problems understanding words said by others. They may not understand what someone is saying in conversation or on television. Bilingual aphasia affects people who speak two languages and have trouble with both after stroke.

-Dysarthria results from damage to the part of the brain that produces speech. As a result, speech may sound slurred. People with dysarthria may have problems saying sounds correctly.

-Apraxia is a problem finding the “right” sounds to use when speaking. The speech may sound “flat.” The person’s tone may not change. He or she may only say one syllable at a time. Aphasia and apraxia of speech almost always occur at the same time.

Talk to your healthcare provider right away about treatments and referrals. Licensed speech-language pathologists can help stroke survivors regain speech and language skills. They can teach survivors how to learn and use writing, gestures and other forms of communication.

Helpful Tips for Talking with Your Loved One:

-Let them speak for themselves. Allow them the time to find the right words.

-Face them and keep eye contact when you talk together.

-Speak slowly with simple words and phrases they can understand, but avoid “talking down” to them. Always speak with respect!

-Use gestures (nods or hand signals), pictures, signs or key words in writing.

-Ask them to repeat things that are not clear. However, avoid asking them to repeat things many times.

-Ask them questions with “yes” or “no” answers.

-Most of all, be patient! Speech recovery can be a slow process.

The most common seizures resulting from strokes are those that occur weeks or months after the initial event. When a region of brain tissue dies during a stroke, it begins to degenerate into scar tissue after a few weeks. The presence of this scar tissue acts a provocative irritant to the normal neurons adjacent to it, precipitation a seizure months or even years later. If you or someone you know have been experiencing seizures after a stroke, ask your primary care provider about an epileptologist in your area, a neurologist who specializes in the diagnosis and treatment of seizures.

If you would like to read a personal article about the signs of seizure, please refer to http://www.everydayhealth.com/blogs/survivingastroke/seizures-affect-stroke-recovery

The rate of stroke climbed about 47 percent in women before giving birth and about 83 percent in new moms in the postpartum period, 12 weeks after giving birth. The risk of stroke rises in pregnancy in part because of a higher volume of blood, but also because of increased risk of high blood pressure, blood clots and migraine headaches. Dramatic fluctuations in hormones and blood pressure in the weeks after giving birth may increase risk during that time, doctors say.

That’s a troubling rise, even for a condition that remains rare, said Dr. Elena V. Kuklina, the study’s lead author, stroke expert and epidemiologist at the federal Centers for Disease Control and Prevention. Overall, strokes were detected in about 71 of every 100,000 delivery hospitalizations by the end of the study period.

Almost all of the increase in strokes during or soon after pregnancy was explained by higher prevalence of high blood pressure and heart disease during pregnancy, said Kuklina. That’s a worrisome trend in a nation where roughly one in five women is obese when she becomes pregnant, a risk factor for both conditions.

If you would like to read more of the personal stories related to this article, please go to this link: http://today.msnbc.msn.com/id/43918460/ns/today-today_health/t/strokes-spike-pregnant-women-new-moms/

The finding, which will be published online today in Proceedings of the National Academy of Sciences, is of great potential significance. Every year brings nearly 800,000 new stroke patients in North America. “That’s one every 40 seconds,” said Gary Steinberg, MD, PhD, director of Stanford’s Institute for Neuro-Innovation and Translational Neurosciences and one of the study’s two senior authors.

The largest single cause of severe neurological disability and the third-leading cause of death in the United States, stroke accounts for an estimated $74 billion annually in related costs, including treatment and additional assistance for the three of every four stroke patients whose ability to perform the activities of daily life is impaired. Strokes are caused by a sudden drop in the flow of blood to the brain resulting from a clot or, less often, bleeding. One of every three stroke patients is under the age of 65. In all, there are 5.4 million stroke survivors in the United States and 15 million worldwide.

The only currently approved drug for stroke — tissue plasminogen activator, or tPA — dissolves clots that keep oxygenated blood from reaching brain tissue. To be effective, tPA must be administered within about 4.5 hours after the stroke. But patients’ brains must first be scanned to rule out the possibility that the stroke was caused by bleeding, which tPA would exacerbate, rather than by blockage

Alpha-B-crystallin appears to act as a sponge, sopping up those bad actors and stopping inflammation from making a bad situation worse. Growing evidence suggests that alpha-B-crystallin can help curb inflammatory activity in the brain.

What Are the Risk Factors of Stroke I Can’t Control?

• Increasing Age: Stroke affects people of all ages, but the older you are, the greater your stroke risk.
• Gender: In most age groups, more men than women have stroke, but more women die from stroke.
• Heredity and Race: People whose close blood relations have had a stroke have higher risk of stroke. African Americans and Hispanic Americans have the highest risk of stroke.
• Prior Stroke: Someone who has had a stroke is at a higher risk of having another one.

What Risk Factors Can I Change or Treat?

• High Blood Pressure: This is the single most important risk factor for stroke because it’s the No. 1 cause of stroke. Know your blood pressure and have it checked at least once every two years. If it’s consistently 140/90 or above, it’s high. Talk to your doctor about how to control it.
• Tobacco Use: Don’t smoke cigarettes or use other forms of tobacco. Tobacco use damages blood vessels.
• Diabetes Mellitus: Having diabetes increases your risk for stroke because it can cause disease of blood vessels in the brain. The risk of stroke is 2 1/2 times higher in people with diabetes.
• High Blood Cholesterol: High blood cholesterol increases the risk of clogged arteries. If an artery leading to the brain becomes blocked, a stroke can result.
• Physical Inactivity and Obesity: Being inactive, obese, or both can increase your risk of cardiovascular disease.
• Excessive Alcohol Intake: Drinking an average of more than one drink per day for women or more than two drinks a day for men raises blood pressure. Binge drinking can lead to stroke.
• Illegal Drug Use: Intravenous drug use carries a high risk of stroke. Cocaine use has also been linked to stroke.
• Poor Diet: Care about what you put in your body! Eat healthy and exercise regularly!
• Lack of Stroke Knowledge: Fewer than half of all individuals over 50 are actually aware of what stroke is, its signs and symptoms, and the importance of seeking immediate medical attention. Know the signs and call 911 immediately.

Emotional distress, especially anxiety, frustration, and depression are common problems after stroke regardless of the age it occurs. Many who experience this have no prior history of depression, and experts are still unsure if it is caused by biological factors provoked by the brain injury or if it is a secondary psychological response to the physical, cognitive, and social impairments produced by the stroke. The first thing that a caregiver or a family member can do is make sure that the stroke victim sees a professional for evaluation and potential treatment for depression. The important thing to remember is that depression is a common and understandable response to the loss and impairment that is produced by the stroke. Taking care of a loved one who has had a stroke can be difficult, so seek professional psychological aid and stay hopeful!