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What to Expect After a Massive Stroke: Side Effects & Methods for Recovery

therapist working on what to expect after a massive stroke

A massive stroke is a significant medical event that can impact one’s ability to carry out the activities of daily living. Due to the severe side effects that may occur, it often leaves both patients and caregivers wondering what to expect after a massive stroke.

To help with this, you’re about to learn how a massive stroke is measured and what side effects may occur. Then you’ll discover over a dozen rehabilitation methods you can use to recover lost abilities.

First, let’s discuss what a massive stroke is.

What Is a Massive Stroke?

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.

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. While you cannot revive dead brain cells, the healthy areas of the brain can step in to pick up some slack.

Before we dig into that process, it helps to understand the prognosis for a massive stroke.

Medical experts often use the NIH Stroke Scale to determine the severity of a stroke. Patients that score between 21 and 42 (the highest possible score) are considered to have suffered a massive stroke.

When asking your medical team what to expect after a massive stroke, they may use your score to provide a rough prognosis. However, every stroke is different and every recovery will be different. This makes it almost impossible for doctors to provide an accurate prognosis for all massive stroke patients.

Therefore, it’s important to follow rehabilitation through to see what’s possible. While one prognosis might suggest recovery stops after 2 years, you might be able to prove that you can pick stroke recovery up after 5 years and still see improvement.

In order to get the most from rehabilitation, it helps to understand how the brain recovers from damage like a massive stroke.

Can a Person Recover from a Massive Stroke?

can a person recover from a massive stroke through neuroplasticity

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, there is hope for recovery.

Neuroplasticity occurs based on experience. Whatever you are repeatedly exposed to, or whatever you repeatedly practice, are the skills that your brain becomes more efficient with.

This is why stroke patients often start rehabilitation before they are even discharged from the hospital. The medical team needs to expose the brain to therapeutic experiences to get the recovery process started as soon as possible.

After discharge from the hospital and inpatient therapy, massive stroke survivors can maximize chances of recovery by continuing with rehabilitation at home. It often takes years to recover the side effects of a massive stroke, but long-term rehabilitation is the best-known way to recover.

Up next, you’ll discover what side effects commonly occur after a massive stroke. Then, you’ll learn over a dozen rehabilitation methods you can use to keep recovery going.

Common Side Effects of Massive Stroke

The location of the stroke has a substantial impact on the side effects experienced. For example, a left-hemisphere stroke is more likely to lead to language difficulties than a right-hemisphere stroke; because the language center of the brain resides in the left hemisphere.

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 focuses on harnessing the brain’s natural ability to heal itself after injury by exposing the brain to therapeutic experiences. The best results occur when rehabilitation is pursued consistently and long-term.

With that said, here are the best rehabilitation methods for massive stroke survivors:

1. Range of motion exercises

therapist work with massive stroke patient

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.

See more ROM exercises »

2. Physical therapy exercises

If you ask your doctor what to expect after a massive stroke, they will often mention physical therapy. It’s a critical component for recovering movement after a massive stroke.

Your physical therapist will help guide you through therapeutic exercises that will help retrain the brain to control your muscles. After discharge from inpatient therapy, it’s important to continue with PT at home.

See all physical therapy stroke exercises »

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.

Learn more about passive exercise »

4. Electrical stimulation

therapist applying electrical stimulation to massive stroke patient

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.

Learn more about electrical stimulation »

5. 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.

Learn more about CIMT »

6. Mirror therapy

what to expect after a stroke with hand paralysis

When you ask your medical team what to expect after a massive stroke, and you suffer from hand paralysis, they will likely suggest participating in mirror therapy.

Mirror therapy can help stroke patients recover hand paralysis by tricking the brain into thinking you’re moving your affected hand. It’s likely that your inpatient rehabilitation center will use this therapy, as it’s growing in popularity due to its effectiveness.

Learn more about mirror therapy »

7. 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.

Learn more about mental practice »

8. 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.

Learn more about botox »

9. Electroacupuncture

acupuncturist applying needles to massive stroke patient

Electroacupuncture is a treatment that combines electrical stimulation with acupuncture. It has been found to help improve spasticity in massive stroke patients when combined with physical therapy.

Alternative treatments are making their way into the stroke rehabilitation field. Don’t be surprised if you ask your therapist what to expect after a massive stroke and they mention some form of electrical stimulation.

Learn more about acupuncture for stroke recovery »

10. Speech therapy

speech language pathologist work with massive stroke patient

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.

Learn more about speech therapy »

11. 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.

Learn more about singing therapy »

12. 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.

Learn more about sensory reeducation »

13. 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.

Learn more about vision restoration therapy »

Understanding Massive Stroke Rehabilitation

A massive stroke is a significant medical event that can alter major abilities, such as movement and communication. Although the side effects can be severe, the brain is capable of recovering from the damage through therapy.

Massive stroke patients should participate in rigorous physical therapy to recover as much movement as possible. Other therapies recommended by the medical team, such as speech therapy, should also be pursued.

The road to recovery will look different for each massive stroke patient. Patients can find hope in neuroplasticity: the brain’s innate ability to rewire itself and bounce back from injury.

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See how Susan is recovering from post-stroke paralysis

“I had a stroke five years ago causing paralysis on my left side which remains today.

I recently began using FitMi.

At first it was difficult for me to be successful with a few of the exercises but the more I use it, the better my scores become.

I have recently had some movement in my left arm that I did not have before.

I don’t know if I can directly relate this to the use of the FitMi but I am not having occupational therapy so I conclude that it must be benefiting me.

The therapy modality motivates me to use it daily and challenges me to compete against my earlier scores.

I heartily recommend it!-Susan, stroke survivor

FitMi is our best-selling home therapy tool because it helps patients of all ability levels.

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