If you’re wondering what to expect after a massive stroke, you’re in the right place.
The road to recovery looks different for everyone because every stroke is different. Fortunately, there are ways to prepare for the road ahead.
You can give yourself the best chance at recovery by understanding the potential side effects and best ways to treat them.
This article will guide you through all of it.
What Is a Massive Stroke?
First up, let’s discuss what a massive stroke is.
A stroke occurs when the supply of blood in the brain is compromised.
When an artery in the brain get clogged by a blood clot, it’s called an ischemic stroke. When an artery in the brain bursts, often from high blood pressure, it’s called a hemorrhagic stroke.
One way to determine the severity of a stroke is to use the NIH Stroke Scale.
Patients that score between 21 and 42 (the highest possible score) are considered to have suffered a massive stroke.
It’s important to note that when adequate blood supply does not reach parts of the brain, it damages the brain tissue. After a massive stroke, the damage is often substantial.
Fortunately, if the stroke was successfully treated, the stroke recovery process can begin to heal the side effects sustained.
Can a Person Recover from a Massive Stroke?
The brain has an innate ability to heal itself after injury, even large injuries like a massive stroke.
Through the phenomenon of neuroplasticity, healthy areas of the brain can take over the functions damaged by stroke. While the recovery process takes time and hard work, never lose hope.
Every day the team here at Flint Rehab hears stories from stroke survivors that recover more function that doctors expected.
One way to maximize your chances of recovery is to experiment with different stroke rehabilitation methods, which you’ll find at the end of this article.
Keep exploring until you find the one that works for you. When you put in the work, the brain will respond.
Next let’s move onto the side effects.
Side Effects of Massive Stroke
The location of the stroke has a substantial impact on the side effects experienced.
Talk to your neurologist to understand where your stroke occurred. This will help you better understand what to expect after a massive stroke.
Here are the most common side effects of a massive stroke:
- Post-stroke paralysis. Loss of motor function is one of the most common stroke side effects. For a mild stroke survivor, the motor loss might manifest as weakness on the affected side (hemiparesis). For a massive stroke survivor, motor loss could mean paralysis on the affected side (hemiplegia).
- Coma after stroke. Falling into coma after stroke is more common after a massive stroke or brain stem stroke. It’s possible that someone in a coma can still hear you, so talk to your loved one and speak words of encouragement.
- Severe speech difficulties. Difficulty with speech after a stroke is often a condition called aphasia. Sometimes, it makes speech more difficult, and in some cases, massive stroke patients cannot talk at all. But remember: there is hope for recovery.
- Difficulty swallowing. A condition called dysphagia can make it difficult for stroke patients to swallow. They may require a feeding tube while in the hospital until swallowing abilities are rehabilitated.
- Difficulty breathing. Some massive stroke patients cannot breath on their own and require a ventilator. These patients require intensive care in a long-term acute hospital.
- Cognitive difficulties. Sometimes a stroke can impair a person’s critical thinking or memory skills. Generally speaking, a severe stroke may lead to more severe cognitive difficulties.
- One sided neglect. A condition called hemineglect can make it hard for a stroke patient to notice things in the environment on their affected side. They may eat only half of their plate because they do not recognize that there’s food on the other half.
- Sensory loss. If the areas of the brain that contribute to sensory loss are compromised, it can lead to sensory disorders after stroke. A common example is numbness after stroke. It can also include tingling sensations, difficulty feeling hot/cold, and more.
- Vision problems. Vision is also processed by the brain. If the visual cortex has been damaged, it can cause vision problems like partial blindness.
- Spasticity and contractures. Spasticity is characterized by muscle stiffness that occurs when a stroke interferes with the signals sent between the brain and body. When spasticity is severe, it can result in contractures where the joints become extremely stiff (as seen with clenched hands after stroke).
This is not a complete list because every stroke is different and some massive strokes will differ from others. However, these are the most common side effects reported.
Next, we’ll discuss methods for recovery.
Methods for Massive Stroke Recovery
Stroke rehabilitation focus on harnessing the brain’s natural ability to heal itself after injury through neuroplasticity. This allows healthy portions of the brain to take over the functions damaged by stroke.
Here are the best rehabilitation methods for massive stroke survivors:
1. Range of motion exercises
After a massive stroke, it’s important to keep the limbs moving and stretch them with ROM exercises. This will help prevent spasticity from worsening and help prevent bedsores.
2. Physical therapy exercises
Physical therapy is a critical component for recovering movement after a massive stroke. A physical therapist will help guide you through therapeutic exercises that will help retrain the brain to control your muscles.
3. Passive exercise
If you struggle with paralysis after a massive stroke, then physical therapy exercises might not be accessible on your own yet. Fortunately, you can start with passive exercise.
Passive exercise involves moving your body parts without exerting effort. For example, you can move your affected arm with your non-affected arm. Although you aren’t “doing it yourself,” this movement still helps spark neuroplasticity.
4. Electrical stimulation
Massive stroke survivors that struggle with paralysis can greatly benefit from electrical stimulation. When electrical currents are applied to the affected muscles, it supplies the brain with a large amount of stimulation. This helps spark the rewiring process. When electrical stimulation is paired with physical therapy exercises, it’s even more effective.
5. Bilateral Training
It can be helpful to try forms of exercise where the non-affected side assists the affected side (bilateral training). A great example is cycling. When one arm or leg can assist the weakened or paralyzed arm or leg, recovery is enhanced.
6. Constraint-Induced Movement Therapy
Constraint-induced movement therapy can help when arm paralysis occurs after a massive stroke. It involves restricting the non-affected arm while forcing use of the affected arm. This type of rehabilitation therapy is difficult, which can be frustrating for the patient, but it’s clinically proven to be effective.
7. Mirror therapy
Mirror therapy can help with hand paralysis recovery. It sparks neuroplasticity by using a tabletop mirror to “trick” the brain into thinking you’re moving your affected hand.
8. Mental practice
Another great way to spark neuroplasticity is by visualizing your affected limbs moving. In the stroke rehabilitation field, this is referred to as mental practice or motor imagery. Best of all, it’s clinically proven to help improve motor deficits after stroke.
9. Antidepressants (for motor improvement)
Conventionally, antidepressants are used to treat post-stroke depression, but now we know that it provides other benefits. Research has found that SSRIs, a type of antidepressant, can help improve motor skills in stroke patients.
10. Botox (for motor improvement)
Massive stroke survivors that struggle with severe spasticity may benefit from botox injections. This drug helps temporarily reduce spasticity. Although the results are temporary, patients can use the improved mobility to practice rehab exercises. That will address the root cause of the spasticity, leading to long-term results.
Electroacupuncture is a treatment that combines electrical stimulation with acupuncture. In one clinical study, it was found to help relieve spasticity after stroke long-term.
12. Music and gaming therapy
The therapeutic effects of music and gaming are also noteworthy in stroke rehabilitation. Some recovery tools, like Flint Rehab’s MusicGlove, utilize the healing effects of music and gaming to help patients recover faster. MusicGlove is clinically proven to improve hand function after stroke after just 2 weeks of use.
13. Singing therapy
If a stroke patient cannot talk at all, they might be able to sing their words. That’s because singing is controlled by the right hemisphere while talking is a left hemisphere function. Singing therapy takes hard work, but it provides hope for getting your voice back.
14. Speech therapy
If you have some ability to speak, but you need help improving your speech and cognitive abilities, then regular speech therapy can help. Working with the experts (Speech-Language Pathologists) can also help you regain the ability to swallow, too.
15. Sensory reeducation
If you struggle with changes in sensation after massive stroke, like numbness or tingling, then sensory reeducation exercises can help. They retrain the brain how to process sensory input, which may help improve sensory issues like numbness.
16. Vision restoration therapy
Vision restoration therapy can help improve vision problems in some stroke patients. These programs utilize eye exercises to help retrain the brain how to process visual input.
Massive Stroke Recovery Time
Now you understand the different side effects and rehab methods for massive stroke. At this point, you might be wondering how long recovery might take.
It’s worth repeating that every stroke is different, so every recovery will be different. Some massive stroke patients may take only months to recover while others may take years.
It can be counterproductive to fixate on how long recovery may take. Instead, turn your attention towards the action you can take today to make tomorrow better.
Remember that the brain responds to stimulus. By pursuing rehabilitation, you’re providing the brain with the stimulation it needs to rewire itself and recover.
Most importantly, never give up hope. Miracles happen every day. Keep pushing.