Section 2: Focus on Strokes

Facts About Strokes

Strokes are the third leading cause of death in the United States. The National Stroke Association reports that for 160,000 of 730,000 Americans who have a stroke annually, the stroke is fatal. A stroke is a life-altering event for the survivor. In the rural setting, strokes affect everyone connected with the survivor and his/her life, work, and farm/ranch business activities.

Definition:

A stroke is a brain injury caused by an interruption of the blood supply to the brain. (Family Caregiver Alliance, 1999)

Causes:

Thromboses account for 60% of all strokes. A thrombosis is a gradual narrowing and eventual blockage of a brain or neck artery where fatty deposits and cholesterol have built up.
Embolisms cause about 20% of all strokes. An embolism is a blockage of the brain or neck artery by an “embolus” or clot. Clots can form in the heart or other parts of the body, or they can be fatty deposits in the linings of the arteries that break off and travel to other parts of the body.
Hemorrhages cause about 20% of all strokes. A hemorrhage is a rupture of an artery in or on the surface of the brain. A hemorrhage can be caused by an aneurysm, a thin, weak area on an artery wall, or a congenital malformation of the brain’s circulatory system. (Family Caregiver Alliance, 1999)

Warning Signs:

Transient ischemic attacks (TIAs) sometimes precede a stroke. TIAs are temporary interruptions of blood flow within or leading to the brain. A stroke happens when the blood flow is permanently cut off to or within the brain. Even if the symptoms are painless and disappear, the following are warning signs that a stroke may soon occur.

Sudden numbness, weakness, or paralysis of the face, arm, or leg, especially if these symptoms are on one side of the body.
Unusual blurred or decreased vision in one or both eyes.
Difficulty understanding simple statements or speaking.
Loss of coordination or balance or dizziness especially if other symptoms are present.
Sudden unexplained severe headache with localized pain.
Difficulty swallowing.

Dial 911 for help if any of these symptoms occur. Every minute counts. The longer a stroke goes untreated, the greater the damage. Emergency medical care should be sought for a stroke as quickly as it is sought for a heart attack. (Mayo Foundation for Medical Education and Research, 1996-1997)

Effects of a Stroke:

The after effects of a stroke depend upon many variables (e.g., location and extent of the stroke, how quickly the body repairs the blood supply to the brain, and how soon other areas of brain tissue can take over the work of the damaged cells). Usually, a stroke involves one side of the brain. The effects may be significant if a large portion of the brain is damaged; effects maybe slight if a small portion is affected.

A stroke that involves the right hemisphere/side of the brain can cause difficulties on the left side of the body including: weakness (hemiparesis); paralysis (hemiplegia); lack of coordination of the arm, leg, and face; lack of sensation in the left side of the body; an overall lack of peripheral vision; problems judging distances; and an inability to think clearly.

A stroke that involves the left hemisphere/side of the brain can cause difficulties on the right side of the body including: weakness, paralysis, lack of coordination of the arm, leg, and face; lack of sensation in the right side of the body; aphasia (e.g., slurred/distorted speech; difficulty listening, writing, reading; difficulty understanding numbers and others’ speech); and slow, cautious, or disorganized behavior. Other effects of a stroke can include difficulty controlling emotions (e.g., unexplained crying, anger, laughter, or inappropriate emotional outbursts); depression; sleep or appetite disturbance; difficulty with adjusting to any lifestyle changes; and difficulties with bowel/bladder control. (Mayo Foundation for Medical Education and Research, 1996-1997)

Recovery and Treatment:

Researchers have found that immediate medical intervention and individualized treatment within the first hours after a stroke can reduce the extent of brain damage. After the stroke survivor’s condition is fully stabilized, their rehabilitation can begin. Each stroke survivor’s symptoms are unique. A rehabilitation plan may include retraining in speech, mobility, activities of daily living, and how to use assistive technology, and in regaining perception of body placement and muscle function.

Controllable Risk Factors:

Controllable risk factors include high blood pressure, obesity, diabetes, stress, lack of exercise, poor diet, smoking, drinking, unnecessary drug use, and elevated cholesterol. (National Stroke Association, 1999)

Support Groups:

After rehabilitation many farmers/ranchers/farm workers or their family members and caregivers need support. Such support can be found through state AgrAbility Projects and their peer support networks. Other community support may be available through hospitals, independent living centers, senior citizen centers, disability service providers, or county human and social services. Resources and support groups can also be found on the Internet.

References

Family Caregiver Alliance, 1999, Fact Sheet: Stroke.

National Stroke Association, 1999, Stroke Facts: Brain Attack Statistics.

American Heart Association, 1999, Stroke (Brain Attack).

Mayo Foundation for Medical Education and Research, The Division of Cerebrovascular Diseases 1996-1997. (See resource section on page 6.)

Organizations

American Heart Association
National Center
7272 Greenville Avenue
Dallas, TX 75231
Phone: 214-373-6300
800-552-6321 (Stroke Connection)
http://www.americanheart.org
AHA affiliates often sponsor stroke programs, clubs, or support groups.

Easter Seals
230 West Monroe Street Suite 1800
Chicago, IL 60606
Phone: 312-726-6200 or 800-221-6827
http://www.easter-seals.org/resources/edu/stroke.asp provides information about strokes and http://www.easter-seals.org/services/medsup.asp provides information about stroke support groups.

National Stroke Association
96 Inverness Drive East, Suite I
Englewood, CO 89112-5112
Phone: 303-649-9299 or 800-STROKES (787-6537)
http://www.stroke.org

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In This Issue
Section 1: Feature Story—AgrAbility for Pennsylvanians Helps Maurer Get Back on Track Section 2: Focus on Strokes Section 3: Assistive Technology Solutions for Farming/Ranching After a Stroke	Section 4: State Project Feature—Volunteer Efforts Provide Direct Assistance to AgrAbility for Pennsylvanian Clients Section 5: Contacts