Author: Rachel Fernandes
From a fetus to a senior, a stroke can affect someone at any age. Strokes require urgent treatment to minimize possible damage and even in the best cases, long-term impairment to the brain is a serious problem.
The two main types of stroke are ischaemic and haemorrhagic. Ischaemic stroke is more common, accounting for 85% of cases. In this type of stroke, a blood clot is responsible for stopping the blood supply in the brain. This restriction of blood flow ultimately means that brain cells in some areas do not receive the necessary oxygen and nutrients. This leads to cell death and therefore, the loss of neural connections. A haemorrhagic stroke, on the other hand, happens when a blood vessel ruptures. The circulation of blood in the brain is disrupted as a result of the accumulated blood and the high pressure that it causes.
Immediate stroke treatment typically involves the intravenous administration of tissue plasminogen activator (TPA). This works by breaking up the blood clot and restoring normal blood flow. In cases where: TPA cannot be given to the patient, they have a history of major bleeding, or the clot is particularly large, doctors may perform an endovascular thrombectomy. A fluorescent dye illuminates the blood vessels in the brain and a catheter is inserted into an artery in the leg. It is directed to the blood clot and doctors are then able to pull the clot out of the body.
The long-term effects of a stroke are variable depending on the scale and site of the damage. Paralysis, vision loss and change in personality are just a few of the effects that can arise after suffering a stroke.
So how can neuroplasticity help stroke survivors? Firstly, what is neuroplasticity? Neuroplasticity details the brain’s ability to reorganize itself by making and eliminating connections between neurons.
Stroke rehabilitation programs rely on facilitating neuroplasticity through repetitive tasks, causing the brain to relearn skills. In discussions about neuroplasticity, “use it or lose it” is a common saying. This phrase neatly summarizes that the skills we do not practice will inevitably worsen with time.
Constraint Induced Movement therapy aims to decrease the impact of a stroke on the upper-limb function of survivors. It was the brainchild of Dr. Edward Taub, who showed that monkeys with deafferented forelimbs were able to learn to use these limbs again. The deafferentation meant that the monkeys had lost somatic sensation in those limbs. Likewise, Constraint Induced Movement therapy stimulates neurorehabilitation, involving the repetitive and intensive use of the affected arm and the restraint of the non-affected arm. This may involve participants wearing a mitt on the non-affected arm, encouraging them to train their affected arm.
Neurorehabilitation is by no means easy or immediate, but for stroke survivors, it is nonetheless a critical option.