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Stroke Rehabilitation Updated 3/2011

Faren H. Williams, MD, Jeremy Golding, MD
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BASICS

  • Description
  • Epidemiology
  • General Prevention
  • Pathophysiology
  • Associated Conditions

DIAGNOSIS

  • Tests
  • Differential Diagnosis

TREATMENT

  • Medication (Drugs)
  • Additional Treatment
  • Complementary and Alternative Medicine
  • Surgery
  • In-patient Considerations

Ongoing Care

  • Follow-Up Recommendations
  • Diet
  • Patient Education
  • Prognosis
The following is an excerpt....
BASICS

Description
  • Post-stroke therapy intended to prevent additional functional loss, avert medical complications, and restore lost function.
  • Majority of stroke rehabilitation should be "low-tech" but "high-touch," involving assessment and treatment by multidisciplinary team (1)[A].
  • System(s) affected: Cardiovascular; Nervous; Musculoskeletal
Epidemiology

Incidence
  • Predominant age: >45 years
  • Predominant sex: Male > Female
Prevalence
  • 2–3% of nondiabetics and 9% of diabetics report a history of stroke.
  • 62 million stroke survivors worldwide (2)
General Prevention
  • Post-stroke, control BP, cholesterol, and obesity
  • Stop smoking
Pathophysiology

Infarction or hemorrhage results in loss of functional central nervous system tissue, resulting in deficits in motor function, sensory function, and impairment of speech and cognition.

Associated Conditions

Conditions commonly associated with stroke that ...

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Figure 18-3 SUBARACHNOID HEMORRHAGE WITH CIRCLEOF WILLIS ANEURYSM. A. CT, Axial Head.Acute blood lies within the subarachnoid space surrounding the branches of the circle of Willis, creating the classic pentagonal shape (arrows). The anterior midline collection lies in the interhemispheric fissure, laterally within the Sylvian fissure and posteriorly over the tentorium. B. Digital Subtraction Angiogram,Cerebral.Contrast, injected after selective catherazation of the internal caroted artery,dearrly identities the aneurysm(arrow). C. Three-Dimensional Time-of-Flight MRA,Cerebral. The aneurysm within the middle cerebral artery isvisible as a localized outpouching (arrow). COMMENT: MRAis a non-invasive modality that can be used to identify aneurysms in high-risk patients. It is, however, a flow-dependent study, and those aneurysms with thrombus or slow flow may not be demonstrated.Credit: Terry R. Yochum, Lindsay J. Rowe, Yochum And Rowe's Essentials of Skeletal Radiology, Third Edition. Philadelphia: Lippincott Williams & Wilkins, 2004.
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