Spontaneous recovery occurs after a stroke when the brain naturally repairs some of the damage it sustained. This recovery is usually seen within the first six months after a stroke and relies on several neural mechanisms.
Today’s article will explain how spontaneous recovery after stroke works, plus some helpful ways to support your brain’s natural repair mechanism.
What is Spontaneous Recovery?
After a stroke, the initial damage due to lost blood flow results in two distinct areas of damage: the core and the penumbra.
The core refers to the area directly hit by the stroke. This area is considered dead and non-salvageable. However, the functions that were controlled by the core area can still return by activating neuroplasticity (more on this in a moment).
On the other hand, the penumbra, which is the area of the brain that surrounds the core, is damaged but not destroyed. Because it is damaged, it does not function correctly. But if this damage to the penumbra can be healed, then many functions will be restored. This is where spontaneous recovery comes in.
Spontaneous recovery refers to the brain’s innate ability to repair and salvage the penumbra. When this occurs, some functions, such as speech, might naturally return without any intervention.
This happens because, when the penumbra was damaged, these functions were impaired, but they were never lost entirely. Once the damage resolves, then the brain can regain those skills.
But how does spontaneous recovery work? And are there any ways to promote it? We’ll answer those questions in the sections below.
How Spontaneous Recovery Works After Stroke
There are three mechanisms that the brain uses to promote spontaneous recovery after stroke. These three are reperfusion, edema management, and diaschisis reversal:
- Reperfusion. This refers to the restoration of blood flow to the damaged areas. The brain can accomplish this in a number of ways, one of which is by elevating blood pressure. For this reason, researchers recommend caution when trying to lower a stroke victim’s blood pressure. While extremely high blood pressure can be dangerous, bringing it down too low might hamper spontaneous recovery.
- Edema management. Decreased oxygen in the brain causes increased swelling (edema), which cuts off blood supply and causes further damage. Therefore, a major part of spontaneous recovery involves reducing edema. This can happen naturally but sometimes requires medication or oxygen therapy. Once the swelling decreases, blood flow can return, and function is usually restored.
- Diaschisis reversal. Diaschisis, also known as neural shock, refers to depressed neural activity due to loss of input from damaged areas of the brain. When blood flow improves and swelling resolves, these areas become more active and functional again.
Diaschisis reversal is the most important part of spontaneous recovery. It is the reason why some of your abilities might suddenly return after stroke.
Spontaneous recovery only occurs during the acute stages of stroke rehabilitation, which usually lasts around six months. But during this time, you can also promote further recovery by taking advantage of your brain’s natural repair mechanisms.
Taking Advantage of Spontaneous Recovery After Stroke
While spontaneous recovery mostly occurs on its own, you can increase the number of abilities you recover by harnessing your brain’s neuroplasticity.
Neuroplasticity refers to the brain’s ability to form new neural pathways. This allows the brain to transfer functions that were once held in damaged parts to new, healthy areas. You can activate neuroplasticity through consistent, therapeutic exercise.
During the period when spontaneous recovery occurs, the brain also enters a heightened state of plasticity. This essentially means that neuroplasticity will operate on turbo-drive, and you can make incredible gains in a short amount of time.
Research shows that stroke patients who participate in rehab make fuller recoveries than those who do not, even though both might experience spontaneous recovery. Therefore, to enhance your recovery, do not just wait for your brain to heal on its own. Give it a boost by practicing stroke rehab exercises every day. You might just surprise yourself by how much progress you make.
What Happens After Six Months?
About six months after stroke, spontaneous recovery will cease, and plasticity will also decrease. This leads to a recovery plateau, where it might seem as though you have peaked in the progress you can make.
In fact, many doctors and therapists used to believe that once a patient reached this stage their recovery had ended. They would, therefore, discourage their patients from continuing with therapy.
Today, however, research has shown that recovery can continue long after six months. That is because you can still activate neuroplasticity even during a plateau. It might take longer to see results than it used to, but recovery still continues. Even five and ten years after a stroke patients can keep regaining abilities.
Therefore, if you have already passed the stage of spontaneous recovery, do not despair. If you can persevere with your therapy, you still have hope for improvement.
Understanding the Brain’s Natural Healing Process
Spontaneous recovery is part of the brain’s natural healing process after stroke. It helps patients regain many of the cognitive and physical abilities they have lost.
However, spontaneous recovery is not the only way to regain function after stroke, nor is it the most reliable. Instead, activating neuroplasticity through consistent exercise is still the surest way.
Even if your progress seems slow and tedious, persevering with therapy will help you recover more movement and cognitive functions. Good luck!
Featured Image: ©iStock/Zinkevych