New Hope for Stroke Victims?
As much as Big Medicine hates to admit it, the brain is still largely uncharted territory. We're constantly learning new things about the brain and how it works. And often, we find that what we thought we knew might not be the case after all.
Scientists long believed, for example, that once we reached adulthood our brains stopped growing new neurons. We now know that this is unequivocally not true. Some parts of the brain, at least, can grow new cells, make new connections, and even increase in size throughout our life spans. The more active and challenged we keep our brains the more likely this is to happen. In the mid-1990s, doctors found that the sleeping pill Ambien could, bizarrely, restore brain function in some people who were in a "persistent vegetative state."
We really don't understand the brain.
This is why even the most counter-intuitive medical findings no longer surprise me when it comes to brain research — such as the finding published in December that a second stroke may help you to recover from the damage of a first stroke.
Can the "window of recovery" be re-opened?
The study was done by Johns Hopkins University. In a nutshell, researchers found that — in mice, at least — rehabilitation after a second stroke may do more than just minimize the damage done by that stroke. It might actually help restore function lost due to a first stroke. Since stroke often causes paralysis or loss of language, the implications for human stroke patients are huge.
Our current understanding of stroke and how the brain works says that the window of recovery after a stroke is no longer than three months. Most healing takes place in the first month. Some healing may continue for up to three months, but that's the limit. The Johns Hopkins study, however, suggests that what we think we know about stroke recovery might be wrong. The brain may be more plastic and adaptable than we ever imagined.
In this study, researchers first taught mice to perform a difficult task — reaching through a slit in their cage to grab food pellets with their paws. Then they induced a stroke. Long after the "window of recovery" was over — when it was far too late for the animals to regain full use of their paws — they were re-trained. Needless to say, they didn't perform nearly as well.
Older research had suggested that, at least in mice, reducing or cutting off oxygen to part of the brain could actually increase the brain's ability to form new connections. So the researchers caused a second stroke to test this out.
They didn't wait for the window of recovery to close this time. They began re-training the mice the day after their strokes — and the results were nothing short of amazing. Not only did the animals recover from the damage caused by the second stroke, they also recovered the function they'd lost due to the first stroke — long, long after this should have been possible. Somehow, the second stroke caused the brain to become more plastic and make new connections in an area that should have been permanently damaged.
Of course, no one is proposing that we cause a second stroke in people living with stroke disability in order to heal them. The study does, however, suggest that for such people who do have a second stroke, aggressive rehabilitation may help them regain some of the abilities they've lost.
Do YOU know the signs of stroke?
Stroke treatment has come a long way in the past few years. Most strokes are caused by clots in the brain's blood vessels. And while 20 years ago there was little we could to but watch and pray, today there are clot-busting drugs and physical interventions that can minimize the damage. Prompt diagnosis and treatment can mean the difference between recovery and lifelong disability. The time between onset of symptoms and getting treatment is critical — the drugs have little effect if they're not given within three hours.
If you think you could be having a stroke, don't hesitate. Call 911 immediately. Minutes matter. And don't try to drive yourself — if you are having a stroke it's much too dangerous. The most common symptoms of a stroke are:
- A sudden, blinding headache
- Trouble speaking — slurring your words or being unable to find the words you want to say
- Trouble understanding the words other people are saying
- Numbness or paralysis in your face or an arm or leg — usually on one side of your body
- Visual problems like double vision
- Loss of balance or coordination
A simple way to remember the signs of a stroke and recognize them in someone else is to remember that you have to act F.A.S.T.
- Face – is one side of their/your face drooping?
- Arms – are you able to use both your arms? Is one weak, or are you unable to move it?
- Speech – is their/your speech slurred or confused?
- Time – time is of the essence. Notice what time it is so you can tell the emergency room staff how long it's been since symptoms started, and get to the hospital as fast as you can.
The Johns Hopkins findings suggest that starting rehabilitation promptly might do even more good than we thought. However, the best way to minimize the effects of a stroke are to get treatment as fast as possible. If you think you or someone else might be having a stroke, don't minimize the symptoms even if they go away in a few minutes. It could be a TIA — a transient ischemic attack, or "mini-stroke." Having one of these means you're likely to have a "real" stroke later on and treatment could save your life.
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