Common Complications After Stroke: What Are They and What Can Be Done?

A stroke occurs when blood flow to the brain is suddenly interrupted, preventing oxygen from reaching the brain and causing brain cells to die quickly. Strokes are one of the leading causes of death and disability, according to the Centers for Disease Control and Prevention (CDC). There are three main types of stroke:

• Hemorrhagic strokes are the least common type of stroke, accounting for only 15% of all strokes, but they are responsible for over 40% of all stroke-related deaths. A hemorrhagic stroke is either a brain aneurysm burst or a weakened blood vessel leaking. Blood spills into or around the brain and creates swelling and pressure, damaging cells and tissue in the brain.
• Ischemic stroke occurs when a blood vessel carrying blood to the brain is blocked by a clot, causing the blood to fail to reach the brain. Elevated blood pressure is a common cause of ischemic stroke. Ischemic strokes account for 87% of all strokes. There are two types of ischemic strokes: embolic and thrombotic. An embolic stroke is when a clot or plaque fragment forms somewhere in the body and travels to the brain. Once in the brain, the clot travels to a blood vessel small enough for the clot to block blood passage. A thrombotic stroke is caused by a blood clot that forms inside one of the arteries supplying blood to the brain.
• Transient ischemic attack (TIA) - Also known as a "mini-stroke," in the instance of a TIA, blood flow to the brain is blocked for a short period of time, typically no more than five minutes. A TIA can exhibit stroke-like symptoms that last less than 24 hours before dissipating. While TIAs generally do not cause permanent brain damage, they are a serious warning sign that a stroke may occur in the future and should not be ignored.

Complications after stroke are the medical, emotional and neurological problems that can affect a survivor after a stroke event. In one study, 85% of patients hospitalized for stroke experienced at least one complication following the stroke. A survivor may experience major or minor complications, depending on the severity of the stroke and other factors. Complications are not always permanent. In many cases, they can be addressed with timely and appropriate treatment.

What Are Common Complications of Stroke?

Deep Vein Thrombosis (DVT)

If blood moves too slowly through your veins, it can cause a clot, or a clump in the blood vessels. When a blood clot forms in a vein, it causes a deep vein thrombosis. DVT is most likely to occur the lower leg or thigh, but can occur in other parts of the body as well. A case of DVT can become life-threatening if a blood clot dislodges and travels to a vital organ. Medication and early mobilization therapy after a stroke can prevent DVT and help a person return to walking and other activities sooner.

Seizures

A stroke causes injury to the brain which results in scar tissue. This scar tissue interrupts the electrical activity in the brain. The disruption of the electrical activity can cause a seizure. Seizures are one of the most common complications of ischemic stroke, affecting 22% of survivors.

Pneumonia 

Pneumonia is a major cause of morbidity and mortality after a stroke. According to the Indiana University School of Medicine, pneumonia is the most common reason for hospital readmission after a stroke. In the case of stroke, trouble swallowing can cause aspiration, or food or liquids being ingested into the airway, which can lead to chest infection or pneumonia.

Cerebral Edema

Swelling or inflammation is part of the body’s natural response to injury. Edema refers to swelling due to trapped fluid. If edema occurs in the brain, however, it can cause severe complications. Cerebral edema can restrict the blood supply to the brain, resulting in brain tissue death. Inflammation of the brain is one of the main complications of ischemic stroke. Getting medical treatment as soon as symptoms of a stroke are observed can help reduce the likelihood of developing severe brain edema.

Bladder Problems

There are a multitude of bladder-related problems that can stem from a stroke. Often, stroke survivors will have a strong urge or need to frequently urinate. When a stroke survivor is unable to relieve themselves appropriately because they are unable to get to the bathroom or remove clothing, it is known as functional incontinence. Other stroke survivors will be incontinent and pass urine without realizing they have done so, known as reflex incontinence. Consequently, when a stroke survivor is unable to fully empty their bladder on their own, it is known as urinary retention. If this occurs, it is likely that the individual will require a catheter to ensure the bladder is fully emptied.  

Clinical Depression

Clinical depression often occurs following a major health crisis. One in four stroke survivors suffers from serious depression. Depression can cause sadness, irritability, difficulty concentrating, hopelessness, apathy, changes in appetite and sleep patterns, and sometimes even suicidal thoughts. It is important to treat depression with the help of mental health providers.

Pressure Sores 

When soft tissue presses against a harder surface, such as a chair or bed, for a prolonged period of time, the blood supply to that area is reduced. This can cause the skin tissue to become damaged or die. When this happens, a pressure sore may form. Prevention is key with pressure sores: proper positioning and appropriate equipment are necessary to avoid them. A stroke survivor should discuss appropriate equipment, like air mattresses and wheelchair cushions, with their doctor or therapist.

Contractures

Contractures are a loss of motion over time due to abnormal shortening of the soft tissue structures spanning one or more joints. These include skin, ligaments, tendons, muscles, and joint capsules. Loss of motion in any of these structures restricts joint mobility, leading to pain, stiffness, and eventually a contracture. Low-load, prolonged stretch is the preferred method for contracture resolution. One such product, the SaeboStretch, uses a revolutionary stretch technology to help maintain or improve motion, while minimizing joint damage and pain.

Shoulder Pain

Shoulder pain occurs in up to 80% of stroke patients who have little or no voluntary movement of the affected limb. Subluxation, or partial dislocation of the shoulder; spasticity of the shoulder; tendonitis; and rotator cuff tears are all possible causes of shoulder pain. Shoulder pain can be treated through proper positioning, including support of the joint with orthotics, as well as early occupational and/or physical therapy intervention. In some cases, if the pain becomes chronic, oral corticosteroids may be prescribed by a physician.  

Falls and Accidents

Common impairments after stroke like imbalance, sensory impairment, weakness, visual problems, and lack of coordination will naturally increase the risk of falls and accidents. Physical and occupational therapy can help reduce this risk and regain stability and lost function. Home modifications and assistive devices can be purchased to help prevent falls and accidents while performing normal daily activities.

Feelings of Social Isolation

Stroke can often impact a survivor’s sense of social place. Their role in the family may change significantly after a stroke: maybe they were the breadwinner and now they are on extended leave from work. A sudden loss of income or intense shift in caregiving needs and expectations may add more stress. Support groups are available for stroke survivors and their loved ones and are a great resource for working through these issues.

How Are Stroke Complications Treated?

Stroke complications are common and stroke rehabilitation professionals know how to structure early treatment for optimal recovery.

Physical Therapy

Early mobilization is key to avoiding complications from paralysis as a result of the stroke. Physical therapy helps stroke survivors improve balance, strength, and movement. A physical therapist will suggest exercises to help the patient become more mobile and to strengthen muscles for standing, walking, bending and other daily activities.

Occupational Therapy

The focus of occupational therapy for stroke survivors is to facilitate participation in life skills by addressing ongoing deficits such as weakness, sensory loss, and cognitive or visual impairments that limit engagement in functional activities. Occupational therapists also help survivors by identifying ways to make a home safer or more accessible for a survivor and teaching strategies for regaining independence after stroke, among other things.

Speech Therapy

Speech therapists evaluate and treat a stroke survivors deficits with communication, cognition, and swallowing.

Other Stroke Rehab Professionals

Recovery from stroke and addressing complications as a result of a stroke event will be a different process for each survivor. There are many different participants of the team who contribute to the recovery of a stroke survivor. Some of the team members may include a primary care physician (PCP), neurologist, physiatrist (doctor of physical medicine), dietitian, nurse, or social worker. Some survivors may need to call upon the services of different team members, depending on what their life was like before the stroke and how the stroke has affected them. Survivors will need to rely on their stroke recovery team, so it is important to have professionals qualified in the issues that are impacting them.

If the Complications Are Common, So Is the Treatment

Although complications do frequently happen after a stroke, they can all be addressed and a successful recovery can be possible. Here at Saebo, we are committed to stroke support and recovery for all survivors and their families. Saebo offers a wide range of products that combine cutting-edge technology with evidence-based rehabilitation techniques. Our offerings and network of Saebo-trained therapists can help you or a loved one to obtain all the necessary tools to maximize stroke recovery.

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All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.