Recovery from a Stroke

By Heidi Moawad, MD

Updated on January 16, 2024

Medically reviewed by Huma Sheikh, MD

Strokes are active, progressive illnesses. They come on suddenly and evolve dramatically over the first few hours. Over the following days, the injury and disability from a stroke usually reach a maximum peak and then stabilize. The suddenness of the brain injury and the resulting neurological deficits can be shocking.

stroke symptoms

This article discusses the recovery period from a stroke and what effects to expect.

Rate of Recovery

The damage of a stroke is fast and aggressive. Recovery, on the other hand, is slow, subtle, and stepwise, with the most rapid changes occurring during the first few weeks following stroke.1

Recovery and healing may occur spontaneously. However, there are medical interventions that can help maximize repair and functional recovery.

Stroke treatment helps improve the overall outcome after a stroke, but treatment does not usually speed up the rate of recovery.

Brain Edema

Stabilization is the first step in recovering from a stroke. After a stroke, most survivors experience some degree of inflammation in the brain, analogous to swelling after an injury, such as the noticeably swollen lump after an injury to the arm or leg.

recovery from a stroke

 

This puffiness, called edema, is part of the body’s repair mechanism. The swelling is composed of a mix of fluid and inflammatory cells.

Because the brain is enclosed in the skull, there is not much space to accommodate swelling. Thus, the edema that develops after a stroke can compress the brain, resulting in increased intracranial pressure and causing stroke symptoms to worsen, sometimes temporarily.2

In some cases in which the swelling is severe, a surgical procedure known as hemicraniectomy may be necessary to relieve the swelling.2

Brain edema begins to develop during the first 24 to 48 hours and reaches its peak three to five days after the onset of a stroke.2 Afterward, the edema decreases gradually over the following weeks.

Often, close monitoring of body fluid concentration in the hospital setting helps reduce the additional brain damage that may be caused by severe edema after a stroke.

Video: “Rehabilitation after a stroke”

For additional information about the rehabilitation after a stroke you can watch a video demonstrating exercises and rehabilitation recommendations.

A set of exercises for rehabilitation of post-stroke patients. Set No1 is  aimed at improving the functions associated  with mobility in bed.

Blood Pressure

Blood pressure typically fluctuates during and after a stroke. At the current time, medical management of blood pressure variations within the first few days after a stroke consists primarily of observation and very limited interference with blood pressure shifts.

Spontaneous blood pressure increases and decreases during and after a stroke is the body’s natural way of maintaining fluid balance and blood flow to the brain at this critical time.3 This leads to limited artificial blood pressure control.

Medical adjustment of blood pressure is reserved for extremely high or extremely low blood pressure that may interfere with healing. Generally, blood pressure alterations resulting from a stroke stabilize within the first two to three days.

Blood Sugar

Some alterations in blood sugar and stress hormones also occur with a stroke.4 These changes stabilize in the first few days and then continue to normalize within the first few weeks after a stroke.

EXERCISES FOR REHABILITATION OF POST-STROKE PATIENTS. SET №2 IS AIMED AT IMPROVING THE MOBILITY AND STABILIZATION OF THE PELVIC COMPLEX

Brain Recovery

Once the body stabilizes, usually with close medical monitoring and a degree of medical management, the brain begins to heal. Medical management is primarily focused on preventing worsening progression of the stroke.

Maintenance of optimal medical conditions, such as fluid control, blood pressure management, and blood sugar regulation help maximize neuronal protection after a stroke. Restoration of brain function and brain cell recovery after a stroke begin within a few days and continue for months and even years before reaching stability.5

Therapy

Therapy is very important in helping the brain recover by stimulating the natural process of neuroplasticity.

Types of Therapy After a Stroke

Speech and swallow therapy, physical therapy, and occupational therapy can aid in regaining function following a stroke.6

Overcoming visual or spatial neglect can be one of the biggest challenges in recovery. Mood affects stroke recovery, and a stroke affects mood, so attention to depression and anxiety is a necessary part of the healing process.

Occupational therapy can recommend modifications, such as changes in the home or bathroom or using assistive devices. The person may also need a caregiver to assist in the activities of daily living.

Side Effects

Other challenges in stroke recovery may include seizures, muscle atrophy, and spasticity.7 In many instances, preventative measures can help to avoid these and other complications.

A SET OF EXERCISES FOR REHABILITATION OF POST-STROKE PATIENTS. SET №3 IS AIMED AT IMPROVING THE MOBILITY AND FUNCTION OF THE UPPER LIMB, STABILIZING THE SHOULDER GIRDLE

Preventing Another Stroke

One of the most important steps in stroke recovery is preventing another stroke. Your healthcare providers will work to find the reasons that the stroke occurred and address them so you can have the highest chance of preventing another one.

By Heidi Moawad, MD
Dr. Moawad is a neurologist and expert in brain health. She regularly writes and edits health content for medical books and publications.

 

Check out the demo version of our  workouts for rehabilitation of post-stroke patients on YouTube

Summary

The time course of a stroke is sudden and fast, and it necessitates urgent medical attention to reduce the damage. However, the recovery process is usually slow and arduous. Discuss your options with your healthcare team so you understand what to expect and how to take the best steps for recovery.

Sources

https://www.verywellhealth.com/how-long-does-it-take-for-a-stroke-to-heal-3146450

  1. Lee KB, Lim SH, Kim KH, et al. Six-month functional recovery of stroke patients: a multi-time-point studyInt J Rehabil Res. 2015;38(2):173-80. doi:10.1097/MRR.0000000000000108
  2. Dostovic Z, Dostovic E, Smajlovic D, Avdic O. Brain edema after ischaemic strokeMed Arh. 2016;70(5):339. doi:10.5455/medarh.2016.70.339-341
  3. Van der jagt M. Fluid management of the neurological patient: a concise reviewCrit Care. 2016;20(1):126. doi:10.1186/s13054-016-1309-2
  4. National Institute of Neurological Disorders and Stroke. Researchers get a handle on how to control blood sugar after stroke.
  5. National Institute of Neurological Disorders and Stroke. Post-stroke rehabilitation fact sheet.
  6. Centers for Disease Control and Prevention. Recovering from stroke.
  7. Xu MY. Poststroke seizure: optimising its managementStroke Vasc Neurol. 2019;4(1):48-56. doi:10.1136/svn-2018-000175
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