After effects of a stroke

Just curious as to the after effects of certain types of strokes. Specifically, the limbs that are rendered useless. Sometimes I see people whose affected arm merely hangs limp at their side while others have their arms drawn up tightly against the chest with the hand curled under. What causes these differences? Is it possible to surgically alter the drawn-up arm so that it hangs down? It seems that in this position, it draws less attention to the stroke victim, who, I’m sure, have enough problems without people staring at them all the time. I don’t stare, BTW, out of morbid curiosity, but out of concern, thinking that SOMETHING can be done. I have a fear of strokes or anything that could adversely affect my brain, which I’ve grown quite attached to, no pun intended.

The consequences of a stroke (cerebral infarction) depend upon what area, and to what extent, the brain has been damaged. Many strokes do not damage significant or substantial areas and have little consequences. Others may cause paraplegia. Usually a person will have a one side weakness, but hemiplegia is possible. If the person is unable to use an arm, it will hang uselessly. I don’t know how others have their arms drawn up against their chest if they have no control over it. Gravity should cause it to fall.

Just wanna bump this once and give it another chance.

If a limb is paralyzed, contractures of the tendons and muscles will often draw it up. The muscle, being without nervous control, may spasm frequently, causing inflammation, and scarring, drawing it tight. Tendons which are unused also tend to contract. If physical therapy is not performed to keep the limbs supple, contractures will occur. As the arm is usually without feeling, there would be no pain associated with it. Surgery to correct the contracture is primarily considered only when the contracture interferes with acts of daily living.

QtM

Sometimes, after a stroke or other damage to the motor cortex of the brain (where voluntary movement originates), the affected limbs default to a position that opposes the effects of gravity. This is because the deeper centres of motor control, which are very basic in purpose - to keep us upright - may have been unaffected or less affected by the stroke and are now unopposed. The result is that the arm flexes up and the leg extends.

Some strokes affect the cortex, some below the cortex, some both. And, there is also a temporal sequence to the progression after a stroke in terms of limbs being flaccid and then getting stiff. All in all, it is very hard to predict what’s going to happen.

I’m not going to try to keep up with the medical pros like Quadgop et. al. But, seeing as I suffered a stroke on 6/15/99, I’ve got a unique perspective.

Practically speaking, the effects of the stroke were bad, but are getting better. Just after the stroke, I suffered extremely bad vertigo, had a hard time speaking clearly, and lost much control of my right arm. After a week, the vertigo was much better, I could speak better, but my right arm didn’t improve much. Now, you would think that since my right arm was most affected, I would experience symptoms consistent with a stroke on the left side of my cerebrum. Well, my left ear became VERY sensetive to sound and my left leg became almost numb.

You did ask about what can be done to reverse the effects. Time heals all wounds, so they (and Todd Rungren) say. Now, three years later, I run marathons, speak with no problem, and can control my arm quite well. However, my ear is still sensitive, my leg is still somewhat numb, and I have had to learn to do everything that requires fine motor skill with my left hand. I now shave, brush my hair, brush my teeth, and write with my left when I used to do it all with my right. Writing has been the hardest adjustment.

Still, the doctors have no answers as to why I had a stroke at 28. They’ve got some vague suspicions, but no answers. I take aspirin each day, but that’s the extent of my treatment (that and the 60 days of physical therapy my insurance said I could have).

Again, this didn’t answer the medical questions, but hopefully it gives you some insight.

There are many deficits that can result from stroke (death of neurons in various parts of the CNS). The deficits depend upon which parts of the neural circuitry are affected.

Stroke related weakness usually results in spasticity…increased tone and contracture of the muscles. This is called Upper Motor Neuron weakness. Sometimes the weakness results in flaccidity, e.g. when spinal motor neurons or cranial motor neurons are affected. This is called Lower Motor Neuron weakness. Some neurodegenerative disorders, like ALS, can lead to both types of weakness in different muscle groups. All of this can be understood if one understands the functional anatomy of the nervous system. Understanding neurological problems is really very topological. Neurologists think the way plumbers, electricians, or electrical engineers think when they analyze plumbing systems or electrical/electronic circuits…

There are some new treatments for post-stroke spasticity and contracture that are promising and avoid surgery (such as tendon transpoition surgery). A promising treatment involves the injection of Botulinum Toxin A (Botox A) into spastic contracted muscles.