Emilia Clarke, from Game of Thrones, suffered 2 strokes!

Emilia Clarke Suffered 2 Brain Aneurysms

The HBO television series Game Of Thrones is not a romantic comedy. But no matter how harrowing the Game of Thrones fictional plot line may get, it is very unlikely to match the distress that series star Emilia Clark experienced in real life, twice.

Clarke, who has played Daenerys Targaryen in the television series since 2011, penned a piece in the New Yorker describing how she had to deal with complications of her brain aneurysms in 2011 and then 2013. A brain aneurysm is otherwise known as a cerebral aneurysm, because if you want to sound smart you can call your brain a cerebrum. An aneurysm is when part of a blood vessel begins to bulge or balloon. This means that the walls of the blood vessel in that location are weakening. Imagine if a blood vessel were like a garden hose. If you were to see part of a garden hose swell like part of a balloon animal, you would concerned that the hose might begin leak or even burst in that area. That’s the same concern with an aneurysm.

Brain Aneurysm

A brain or cerebral aneurysm is when the aneurysm occurs in one of the blood vessels, usually an artery, that supplies blood to parts of the brain. A brain aneurysm bursting or rupturing is a major emergency. That is what happened to Clarke in 2011.

As she described it in her article, she was about to work out with her trainer on the morning of February 11, 2011, when she “started to feel a bad headache coming on. I was so fatigued that I could barely put on my sneakers.” Her struggles continued through the workout:

Then my trainer had me get into the plank position, and I immediately felt as though an elastic band were squeezing my brain. I tried to ignore the pain and push through it, but I just couldn’t. I told my trainer I had to take a break. Somehow, almost crawling, I made it to the locker room. I reached the toilet, sank to my knees, and proceeded to be violently, voluminously ill. Meanwhile, the pain—shooting, stabbing, constricting pain—was getting worse. At some level, I knew what was happening: my brain was damaged.

She was eventually helped to Whittington Hospital in the United Kingdom, where an MRI of her head revealed that she was suffering a subarachnoid hemorrhage. A subarachnoid hemorrhage is a bleed into the space between the brain and the membranes surrounding the brain. Apparently, she had developed an aneurysm in an artery in her brain, which then had ruptured and started bleeding. Her description of events in the New Yorker piece matched the classic symptom of a ruptured cerebral aneurysm: the sudden onset of the worst headache of your life. Other common symptoms are nausea, vomiting, double vision, sensitivity to light, necks stiffness, seizures, disorientation, and loss of consciousness.

There are “emergencies”, like your TV or Tivo not working when Games of Thrones is being broadcast. There are bigger emergencies like having explosive diarrhea with no toilet in site. Then there are your-life-is-in-serious-danger-every minute-counts emergencies such as a subarachnoid hemorrhage. You can’t just walk off a subarachnoid hemorrhage. If you do not get treatment as soon as possible, you will die.

According to the National Institute of Neurological Disorders and Stroke (NINDS), each year ruptures of cerebral aneurysms occur in approximately 30,000 Americans. About a quarter of these unfortunate people do not even survive longer than 24 hours. Another quarter pass away within 6 months. That means ruptured cerebral aneurysms will kill at least 50% of people. Many of the surviving half will suffer long-term or permanent loss of brain function. It is possible to survive and eventually fully recover, but the likelihood depends on the size and location of the bleed and the speed at which proper treatment can be administered and the blood vessel can be repaired.

Thus, Clarke had to have emergency surgery to repair the artery. While this may sound simple, in real life there’s no CGI, no props, no stand-in brains. As I wrote previously for Forbes, when brain cells can’t get blood and thus oxygen, they die within 5 minutes. Bleeding and the resulting inflammation can cause further damage to the brain. Thus, surgeons have to act quickly to repair things as much as they can while moving delicately enough to not cause further damage. Besides stopping the bleeding and repairing the artery, other typical treatments for a ruptured cerebral aneurysm include giving anti-seizure drugs to prevent seizures and calcium channel-blocking drugs to prevent the blood vessels from having spasms that can then result in a stroke. Clarke wrote:

I remember being told that I should sign a release form for surgery. Brain surgery? I was in the middle of my very busy life—I had no time for brain surgery. But, finally, I settled down and signed. And then I was unconscious. For the next three hours, surgeons went about repairing my brain. This would not be my last surgery, and it would not be the worst. I was twenty-four years old.

This first surgery was “minimally invasive,” lasting three hours. Minimally invasive means not completely opening up the body, in this case the skull, to reach the part that needs fixing. Instead, to reach the artery in her brain, the doctors created a small hole in the femoral artery in her groin and then threaded a tube through her connected arteries up into the affected artery in her brain. They could then push a coil, a spiral-shaped object, through the tube, up to where the ruptured aneurysm was. The coil could then expand like a spring, form a clot, and consequently seal off the aneurysm.

This Cleveland Clinic video shows the different ways to repair an aneurysm:

The recovery after such an emergent procedure is the opposite of a picnic, unless that picnic involves suffering severe pain and other symptoms, having a tube constantly down your throat, and not knowing whether you will live, die, or permanently lose some type of body or mental function. During the first two weeks after such a surgery, a patient could go downhill very quickly, downhill in a bad way and not a skiing way. Therefore, a patient’s progress during this post-operative period really determines which direction he or she will eventually go.

Clarke wrote how she managed to get through these two weeks, making good progress. However, shortly thereafter, another issue emerged. When she was asked to say her name, she couldn’t remember it. Granted her full name is Emilia Isobel Euphemia Rose Clarke, which is at least two more names to remember than what most people have, and four more names than a Brazilian soccer star would have. But her inability to say her name and instead utter what she described as “nonsense”was the result of her suffering a type of aphasia. Aphasia is a general term for an impaired ability to either use or understand words that results from injury to the parts of the brain that control language.

Depending on the amount and location of the brain damage, an aphasia can be temporary or permanent. Fortunately, in Clarke’s case, the aphasia disappeared after about a week. As she described, one month after the surgery, she was able to leave the hospital and soon resume her acting career. One caveat was that the doctors had discovered a “smaller aneurysm on the other side of my brain, and it could ‘pop’ at any time. The doctors said, though, that it was small and it was possible it would remain dormant and harmless indefinitely.”

Fast forward to 2013, when she underwent a brain scan in New York City to do a routine check on her other aneurysm, the doctors, in her words, found that “The growth on the other side of my brain had doubled in size, and the doctor said we should ‘take care of it.’” Doctors first tried another minimally invasive procedure, but when things went awry and she began bleeding in her head, an emergent open surgery was necessary. The recovery from this much more invasive and involved surgery was significantly tougher, according to Clarke. But as she explained, she eventually fully recovered, except possibly that the one thing it may have “robbed me of is good taste in men.”  Her experience has inspired her to develop with others a charity called SameYou that “aims to provide treatment for people recovering from brain injuries and stroke.”

As you can see, Clarke, who is now 32 year old, had a brain aneurysm rupture and another that was at risk of rupturing while she was in her 20’s. How unusual was this for someone so young? Well, no one knows for sure what percentage of people of different ages are walking around with cerebral aneurysms. Most of the time, a cerebral aneurysm that is not leaking or has not ruptured will produce no symptoms. The exception is when the bulge begins pushing on some other structure, like a nerve to cause numbness, weakness, paralysis, or pain. If the aneurysm is near the eye or a structure that affects the eye, eye-related symptoms like a dilated pupil or changes in vision may occur. Currently, the only way to really determine how many people actually have cerebral aneurysms would be to give everyone regular brain scans, which would be ridiculously expensive. Plus, brain scans may not always detect aneurysms and could have false positives that could lead to unnecessary tests and procedures.

Cerebral aneurysms could evolve at any age but are probably more likely the older you get. That’s because an aneurysm forms when the blood vessel wall weakens and becomes thinner and more pliable, which may occur with age. High blood pressure can cause such weakening just as a garden hose may not be able to handle being connected to a fire hydrant. Certain less common infections, trauma to the head, or brain tumors can weaken blood vessel walls as well. Then, there are conditions such as connective tissue disorders, polycystic kidney disease, and arteriovenous malformations, which are abnormal connections between arteries and veins that then change how blood flows and potentially raise blood pressure in parts of the brain circulation.

What may make an existing aneurysm rupture? Anything that weakens the aneurysm walls like high blood pressure and smoking. That means anything that raises blood pressure like cocaine or other stimulant use can lead to rupture. But not all ruptures necessarily need a precipitating event. Aneurysms can just grow bigger and bigger over time until like a balloon that’s overstretched, it pops, and bad stuff ensues.

As Clarke described in her piece, she apparent kept these events quiet until now for fear of repercussions their revelation may have on her career. Such concerns are natural. Nonetheless, her revealing her medical history may now bring more needed attention to these silent time bombs. More attention could help more people get proper treatment in a more timely fashion. It could bring more attention and care to those who have suffered brain injury. It could also galvanize more research to identify better ways to detect and treat cerebral aneurysms. More awareness is especially important in this day and age when science, scientific research, and funding for scientific research are being treated a bit like many of the Game of Thrones characters in how they are being cut and eliminated.

Follow me on Twitter @bruce_y_lee and visit our Global Obesity Prevention Center (GOPC) at the Johns Hopkins Bloomberg School of Public Health. Read my other Forbes pieces here

Comprehensive Speech Language Therapy Services

After a stroke, patients can experience a wide range of symptoms depending on where the stroke occurred in the brain and how severe it was.

Patients who experience facial paralysis and speech impairment after a stroke typically need ongoing speech therapy. At Memorial Regional Hospital, Speech Language Pathologist Joan Parnell works with doctors and patients to develop specialized treatment plans. The treatment begins by understanding the area in the brain where the stroke has occurred.

“Every patient is different, so it varies patient to patient,” Parnell said. “Their age, prior level of function, severity of CVA (cerebrovascular accident), and a patient’s motivation all have an affect on how the treatment is provided and the outcome of treatment.”

A stroke happens when blood flow to an area of the brain is cut off. Brain cells are then deprived of oxygen and begin to die.

“When brain cells die during a stroke, abilities controlled by that area of the brain, such as memory and muscle control, are lost,” according to the National Stroke Association.

When a stroke happens in the left side of the brain, the right side of the body is affected, and when a stroke happens in the right side of the brain, the left side of the body is affected.

The left side of the brain involves speech and language. The left frontal lobe, or Broca’s area, involves speech production. Impairment here usually means the patient can’t form words properly and has slurred or slow speech but can typically understand, she said. The left temporal lobe, or Wernicke’s area, is responsible for comprehension of language.

“When someone has facial paralysis, typically, a speech therapist would have the patient do exaggerated lip, face, tongue exercises, such as smiling, puckering of lips, protruding, lateralizing, and elevating tongue,” Parnell said. “The patient’s prior level of health, severity of CVA/TBI, and motivation/diligence of performing treatment tasks will affect outcomes. Speech therapy is just like any other task — if you don’t practice outside of the treatment room, then typically, your progress is not as great as someone who does.”

Beyond speech

Following any brain injury, some patients may experience depression and feel their intelligence has been taken away, Parnell said.

“I typically educate them that they haven’t lost their intelligence, but that a storm has come through their brain and damaged some of the lines/wires, like electrical and phone wires would be damaged in a bad storm,” she said. “They then need to perform therapy to improve the damaged wires of their brain. They may not only feel ‘dumb’ — as they often say to me — or they are embarrassed, so I celebrate the smallest successes to improve their confidence and keep building from there.”

Because these patients have experienced this storm within their brains, it’s important for friends, family and other caregivers to be patient. Parnell suggests keeping commands and directions simple, allowing the person plenty of time to communicate and not answering questions for them.

“Continue to treat them as a loved one, not as a patient.”

For more information about stroke treatment at Memorial Regional Health, visit memorialregionalhealth.com.

Now…I understand the problems I had!

New treatment offers hope for better stroke recovery. Spatial neglect often occurs after damage to the right side of the brain, making it difficult for stroke survivors to see things on their left.

Eating food from only the right side of the plate, shaving or applying make-up to only one side of the face, and running into objects on the left are common traits post stroke and for some survivors current therapies aren’t working.

University of Queensland researchers are leading a world-first project that might help overcome disability that can affect many everyday activities for stroke survivors.

UQ School of Human Movement and Nutrition Sciences researcher Associate Professor Timothy Carroll said the research would investigate a new therapy in which robots would guide the hand to retrain the stroke survivor’s brain.

“The neuropsychological condition – called spatial neglect – often occurs after damage to the right hemisphere of the brain, making it difficult for stroke survivors to pay attention to the left side of space,” Associate Professor Carroll said.

“Up to 85 per cent of right hemisphere stroke survivors have reduced ability to attend to the left side of space, which can affect many activities.

“A person might fail to eat the food on the left half of their plate, and they might only shave or apply make-up to the left side of their face.

“They may collide with objects or structures such as door frames on their left.

“At present there is no satisfactory treatment for people with spatial neglect.”

One current treatment involves reaching towards visual targets while wearing spectacles containing prisms that shift the entire field of view towards the right.

To reach accurately while wearing the prism spectacles, people with spatial neglect must learn to reach targets on their neglected side.

Dr Carroll said the treatment’s effectiveness varied dramatically for different patients; ranging from long-lasting functional improvement after a single session to no benefit at all.

“We are testing a new approach, in which we use a robot to physically push the person’s hand to one side while they are reaching, instead of using prisms to distort vision,” he said.

“We hope to show that learning to move straight when the robot pushes the hand to one side will help people with neglect to better orient attention to the left side of space.

“This will help us to better understand the links between attention and movement after stroke, and may lead to new rehabilitation approaches for stroke survivors with attention deficits in the future.”

Stroke Foundation figures show that more than 475,000 Australians were living with the effects of stroke in 2017, with this number predicted to rise to one million by 2050.

The UQ researchers are looking for stroke survivors with damage to the right hemisphere to participate in a single two-hour testing session at UQ’s St Lucia campus in Brisbane.

Volunteers must be able to sit in a stable position for an hour, have no significant vision impairments (normal spectacles are fine), and be able to effectively reach to objects with their right arm.

Those interested in participating should email Dr Carroll on timothy.carroll@uq.edu.au, or call UQ’s School of Human Movement and Nutrition Sciences on +61 7 3365 6240.

Media: Associate Professor Timothy Carroll, timothy.carroll@uq.edu.au, 0431 530 339, Kirsten O’Leary, UQ Communications, k.oleary@uq.edu.au, +61 7 3365 7436.

Brain Basics

shutterstock_175160774Source: National Institute of Neurological Disorders and Stroke

Introduction

If you’re like most Americans, you plan your future. When you take a job, you examine its benefit plan. When you buy a home, you consider its location and condition so that your investment is safe. Today, more and more Americans are protecting their most important asset—their brain. Are you?

Stroke ranks as the fourth leading killer in the United States. A stroke can be devastating to individuals and their families, robbing them of their independence. It is the most common cause of adult disability. Each year approximately 795,000 Americans have a stroke, with about 160,000 dying from stroke-related causes. Officials at the National Institute of Neurological Disorders and Stroke (NINDS) are committed to reducing that burden through biomedical research.

What is a Stroke?

A stroke, or “brain attack,” occurs when blood circulation to the brain fails. Brain cells can die from decreased blood flow and the resulting lack of oxygen. There are two broad categories of stroke: those caused by a blockage of blood flow and those caused by bleeding into the brain. A blockage of a blood vessel in the brain or neck, called an ischemic stroke, is the most frequent cause of stroke and is responsible for about 80 percent of strokes. These blockages stem from three conditions: the formation of a clot within a blood vessel of the brain or neck, called thrombosis; the movement of a clot from another part of the body such as the heart to the brain, called embolism; or a severe narrowing of an artery in or leading to the brain, called stenosis. Bleeding into the brain or the spaces surrounding the brain causes the second type of stroke, called hemorrhagic stroke.

Two key steps you can take will lower your risk of death or disability from stroke: control stroke’s risk factors and know stroke’s warning signs. Scientific research conducted by the NINDS has identified warning signs and a large number of risk factors.

What are the warning signs of a Stroke?

Warning signs are clues your body sends that your brain is not receiving enough oxygen. If you observe one or more of these signs of a stroke or “brain attack,” don’t wait, call a doctor or 911 right away!

  • Sudden numbness or weakness of face, arm, or leg, especially on one side of the body
  • Sudden confusion, or trouble talking or understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, or loss of balance or coordination
  • Sudden severe headache with no known cause

Other danger signs that may occur include double vision, drowsiness, and nausea or vomiting. Sometimes the warning signs may last only a few moments and then disappear. These brief episodes, known as transient ischemic attacks or TIAs, are sometimes called “mini-strokes.” Although brief, they identify an underlying serious condition that isn’t going away without medical help. Unfortunately, since they clear up, many people ignore them. Don’t. Paying attention to them can save your life.

What are the risk factors for a Stroke?

A risk factor is a condition or behavior that occurs more frequently in those who have, or are at greater risk of getting, a disease than in those who don’t. Having a risk factor for stroke doesn’t mean you’ll have a stroke. On the other hand, not having a risk factor doesn’t mean you’ll avoid a stroke. But your risk of stroke grows as the number and severity of risk factors increases.

Some factors for stroke can’t be modified by medical treatment or lifestyle changes.

  • Age.  Stroke occurs in all age groups.  Studies show the risk of stroke doubles for each decade between the ages of 55 and 85.  But strokes also can occur in childhood or adolescence.  Although stroke is often considered a disease of aging, the risk of stroke in childhood is actually highest during the perinatal period, which encompasses the last few months of fetal life and the first few weeks after birth.
  • Gender.  Men have a higher risk for stroke, but more women die from stroke.  Men generally do not live as long as women, so men are usually younger when they have their strokes and therefore have a higher rate of survival.
  • Race.  People from certain ethnic groups have a higher risk of stroke.  For African Americans, stroke is more common and more deadly—even in young and middle-aged adults—than for any ethnic or other racial group in the United States.  Studies show that the age-adjusted incidence of stroke is about twice as high in African Americans and Hispanic Americans as in Caucasians.  An important risk factor for African-Americans is sickle cell disease, which can cause a narrowing of arteries and disrupt blood flow. The incidence of the various stroke subtypes also varies considerably in different ethnic groups.
  • Family history of stroke.  Stroke seems to run in some families.  Several factors may contribute to familial stroke.  Members of a family might have a genetic tendency for stroke risk factors, such as an inherited predisposition for high blood pressure (hypertension) or diabetes.  The influence of a common lifestyle among family members also could contribute to familial stroke.

What are the treatable factors?

Some of the most important treatable risk factors for stroke are:

  • High blood pressure, or hypertension.
    Hypertension  is by far the most potent risk factor for stroke. Hypertension causes a two-to four-fold increase in the risk of stroke before age 80.  If your blood pressure is high, you and your doctor need to work out an individual strategy to bring it down to the normal range. Some ways that work: Maintain proper weight. Avoid drugs known to raise blood pressure. Eat right:  cut down on salt and eat fruits and vegetables to increase potassium in your diet. Exercise more. Your doctor may prescribe medicines that help lower blood pressure. Controlling blood pressure will also help you avoid heart disease, diabetes, and kidney failure.
  • Cigarette smoking. 

    Cigarette smoking causes about a two-fold increase in the risk of ischemic stroke and up to a four-fold increase in the risk of hemorrhagic stroke.  It has been linked to the buildup of fatty substances (atherosclerosis) in the carotid artery, the main neck artery supplying blood to the brain. Blockage of this artery is the leading cause of stroke in Americans. Also, nicotine raises blood pressure; carbon monoxide from smoking reduces the amount of oxygen your blood can carry to the brain; and cigarette smoke makes your blood thicker and more likely to clot. Smoking also promotes aneurysm formation. Your doctor can recommend programs and medications that may help you quit smoking. By quitting, at any age, you also reduce your risk of lung disease, heart disease, and a number of cancers including lung cancer.

  • Heart disease. 

    Common heart disorders such as coronary artery disease, valve defects, irregular heart beat (atrial fibrillation), and enlargement of one of the heart’s chambers can result in blood clots that may break loose and block vessels in or leading to the brain. Atrial fibrillation—which is more prevalent in older people—is responsible for one in four strokes after age 80, and is associated with higher mortality and disability. The most common blood vessel disease is atherosclerosis. Hypertension promotes atherosclerosis and causes mechanical damage to the walls of blood vessels. Your doctor will treat your heart disease and may also prescribe medication, such as aspirin, to help prevent the formation of clots. Your doctor may recommend surgery to clean out a clogged neck artery if you match a particular risk profile. If you are over 50, NINDS scientists believe you and your doctor should make a decision about aspirin therapy. A doctor can evaluate your risk factors and help you decide if you will benefit from aspirin or other blood-thinning therapy.

  • Warning signs or history of TIA or stroke. 

    If you experience a TIA, get help at once. If you’ve previously had a TIA or stroke, your risk of having a stroke is many times greater than someone who has never had one. Many communities encourage those with stroke’s warning signs to dial 911 for emergency medical assistance. If you have had a stroke in the past, it’s important to reduce your risk of a second stroke. Your brain helps you recover from a stroke by asking the unaffected brain regions to do double duty. That means a second stroke can be twice as bad.

  • Diabetes. 

    In terms of stroke and cardiovascular disease, having diabetes is the equivalent of aging 15 years. You may think this disorder affects only the body’s ability to use sugar, or glucose. But it also causes destructive changes in the blood vessels throughout the body, including the brain. Also, if blood glucose levels are high at the time of a stroke, then brain damage is usually more severe and extensive than when blood glucose is well-controlled. Hypertension is common among diabetics and accounts for much of their increased stroke risk. Treating diabetes can delay the onset of complications that increase the risk of stroke.

  • Cholesterol imbalance.  Low-density lipoprotein cholesterol (LDL) carries cholesterol (a fatty substance) through the blood and delivers it to cells.  Excess LDL can cause cholesterol to build up in blood vessels, leading to atherosclerosis.  Atherosclerosis is the major cause of blood vessel narrowing, leading to both heart attack and stroke.
  • Physical inactivity and obesity.  Obesity and inactivity are associated with hypertension, diabetes, and heart disease.  Waist circumference to hip circumference ratio equal to or above the mid-value for the population increases the risk of ischemic stroke three-fold.

Do you know the risk?

Some of the most important risk factors for stroke can be determined during a physical exam at your doctor’s office. If you are over 55 years old, the worksheet in this pamphlet can help you estimate your risk of stroke and show the benefit of risk factor control.

The worksheet was developed from NINDS-supported work in the well-known Framingham Study. Working with your doctor, you can develop a strategy to lower your risk to average or even below average for your age.

Many risk factors for stroke can be managed, some very successfully. Although risk is never zero at any age, by starting early and controlling your risk factors you can lower your risk of death or disability from stroke. With good control, the risk of stroke in most age groups can be kept below that for accidental injury or death.

Americans have shown that stroke is preventable and treatable. In recent years, a better understanding of the causes of stroke has helped Americans make lifestyle changes that have cut the stroke death rate nearly in half.

Scientists at the NINDS predict that, with continued attention to reducing the risks of stroke and by using currently available therapies and developing new ones, Americans should be able to prevent 80 percent of all strokes.

Score your stroke risk for the next 10 years-MEN

Key:  SBP = systolic blood pressure (score one line only, untreated or treated); ; Diabetes = history of diabetes; Cigarettes = smokes cigarettes; CVD (cardiovascular disease) = history of heart disease; AF = history of atrial fibrillation; LVH  = diagnosis of left ventricular hypertrophy

Points 0 +1 +2 +3 +4 +5 +6 +7 +8 +9 +10
Age 55-56 57-59 60-62 63-65 66-68 69-72 73-75 76-78 79-81 83-84 85
SBP-untrd 97-105 106-115 116-125 126-135 136-145 146-155 156-165 166-175 176-185 186-195 196-205
or SBP-trtd 97-105 106-112 113-117 118-123 124-129 130-135 136-142 143-150 151-161 162-176 177-205
Diabetes No Yes
Cigarettes No Yes
CVD No Yes
AF No Yes
LVH No Yes

 

Your Points 10-Year Probability
1 3%
2 3%
3 4%
4 4%
5 5%
6 5%
7 6%
8 7%
9 8%
10 10%
11 11%
12 13%
13 15%
14 17%
15 20%
16 22%
17 26%
18 29%
19 33%
20 37%
21 42%
22 47%
23 52%
24 57%
25 63%
26 68%
27 74%
28 79%
29 84%
30 88%

 

Compare with Your Age Group Average 10-Year Probability of Stroke
55-59 5.9%
60-64 7.8%
65-69 11.0%
70-74 13.7%
75-79 18.0%
80-84 22.3%

 

Score your stroke risk for the next 10 years-WOMEN

Key:  SBP = systolic blood pressure (score one line only, untreated or treated); ; Diabetes = history of diabetes; Cigarettes = smokes cigarettes; CVD (cardiovascular disease) = history of heart disease; AF = history of atrial fibrillation; LVH  = diagnosis of left ventricular hypertrophy

Points 0 +1 +2 +3 +4 +5 +6 +7 +8 +9 +10
Age 55-56 57-59 60-62 63-64 65-67 68-70 71-73 74-76 77-78 79-81 82-84
SBP-untrd 95-106 107-118 119-130 131-143 144-155 156-167 168-180 181-192 193-204 205-216
or SBP-trtd 95-106 107-113 114-119 120-125 126-131 132-139 140-148 149-160 161-204 205-216
Diabetes No Yes
Cigarettes No Yes
CVD No Yes
AF No Yes
LVH No Yes

 

Your Points 10-Year Probability
1 1%
2 1%
3 2%
4 2%
5 2%
6 3%
7 4%
8 4%
9 5%
10 6%
11 8%
12 9%
13 11%
14 13%
15 16%
16 19%
17 23%
18 27%
19 32%
20 37%
21 43%
22 50%
23 57%
24 64%
25 71%
26 78%
27 84%

 

Compare with Your Age Group

Average 10-Year Probability of Stroke

55-59 3.0%
60-64 4.7%
65-69 7.2%
70-74 10.9%
75-79 15.5%
80-84 23.9%

 

This example helps you assess your risk of stroke. Tally your points to score your
stroke risk over the next 10 years.

Martha, age 65, wanted to determine her risk for having a stroke, so she took this stroke risk profile. This is how she arrived at her 10-year probability risk for having a stroke:

Age 65
SBP – treated, 107-113
Diabetes – No
Cigarettes – Yes
CVD – No
AF – Yes
LVH – No
4 points
2 points
0 points
3 points
0 points
6 points
0 points

TOTAL

15 points

Interpretation:
15 points carries a 16 percent, 10-year probability of having a stroke. If Martha quits smoking she can reduce her points to 12, which carries a 9 percent, 10-year probability of having a stroke.

Her current point total does not mean Martha will have a stroke, but serves as a wake-up call to ways she can lower her risk or even prevent a stroke. A lower percent score doesn’t mean that Martha won’t have a stroke, only that she is at a lower risk of having one.

No matter what your score is, it is important to work on reducing your risk factors as Martha did in this example by quitting smoking.

Source:  D’Agostino, R.B.; Wolf, P.A.; Belanger, A.J.; & Kannel, W.B.  “Stroke Risk Profile:  The Framingham Study.”  Stroke, Vol. 25, No. 1, pp. 40-43, January 1994.

Many risk factors for stroke can be managed, some very successfully. Although risk is never zero at any age, by starting early and controlling your risk factors you can lower your risk of death or disability from stroke. With good control, the risk of stroke in most age groups can be kept below that for accidental injury or death.

Americans have shown that stroke is preventable and treatable. In recent years, a better understanding of the causes of stroke has helped Americans make lifestyle changes that have cut the stroke death rate nearly in half.

Scientists at the NINDS predict that, with continued attention to reducing the risks of stroke and by using currently available therapies and developing new ones, Americans should be able to prevent 80 percent of all strokes.

New Therapy May Help Stroke Survivors Move Hand

 shutterstock_346003820

Posted by Dennis Thompson, HealthDay Reporter 

In the experimental therapy, patients use their good hand to help their brain regain control over the paralyzed hand, explained lead researcher Jayme Knutson, an assistant professor of physical medicine and rehabilitation at Case Western Reserve University School of Medicine in Cleveland.

A sensor-laden glove worn on the patient’s good hand sends signals to electric stimulators attached to the paralyzed hand, prompting the muscles in the inert hand to mirror the movements of the functioning hand, Knutson said.

During physical therapy patients think about opening both hands at the same time, as the electrical stimulation forces the paralyzed hand to reflect the movements of the good hand.

“We think we’re training the brain,” Knutson said. “The stimulation coincides with the patients’ attempt to open their hand. That sort of puts the brain back in control, in a roundabout way. The brain is active in attempting to open the hand.”

Electrical stimulation already has been in use as a therapy to help restore movement in a paralyzed hand, but up until now the stimulator has automatically opened and closed the hand at several-second intervals without any input from the patient, Knutson said.

Knutson and his colleagues tested their new approach in a clinical trial involving 80 stroke survivors.
For 12 weeks, half the survivors received electrical stimulation therapy using the new “mirroring” therapy. The other half also used an electrical stimulator, but in standard therapy that mechanically opened and closed the inert hand with no input from the brain.

Both groups used their assigned electrical stimulator on their own at home for 10 hours a week. They also spent three hours a week practicing hand tasks with an occupational therapist in the lab.

Prior to and six months following therapy, all patients were given a standard dexterity test that measured the number of blocks they could pick up, lift over a barrier and release in another area on a table within a 60-second period.

Patients who received the new therapy experienced markedly better improvement than those in the control group. There were able to move an average of 4.6 blocks more than they had prior to therapy, compared with an improvement of 1.8 blocks for those who received standard therapy.

Improvement was greatest for people who received the new therapy less than two years following their stroke, the researchers reported. These patients experienced an improvement of 9.6 blocks on the dexterity test, compared to a 4.1-block improvement in the standard therapy group.

“It’s common to see the earlier you receive therapy after a stroke, the better able the brain is to recover,” Knutson said. If people delay therapy, the brain learns compensatory “bad habits” that become ingrained and are difficult to reverse, he said.

By the end of the treatment, 97 percent of patients who received the new therapy felt they could use their hand better than at the start of the study, researchers report.

Placing the brain somewhat in charge appears to “work on the wiring” of the nervous system, said Daniel Lackland, a professor of translational neuroscience at the Medical University of South Carolina in Charleston.

“This electrical stimulation is supplementing the body’s electrical system at the source of where you want the action to be,” Lackland said. “You’re building up that system. You’re enhancing the electrical system that’s already there.”

Both Knutson and Lackland said larger follow-up trials are needed before the technology can be submitted for U.S. Food and Drug Administration approval. Those trials are in the works, but it will likely be years before the therapy is widely available, Knutson said.

“You don’t want to give people false hope,” said Lackland, a spokesman for the American Stroke Association. “We’re not quite ready. But it is heading in a direction where there’s a therapy that’s relatively easy to use, and it’s going to be helpful for the appropriate type of person.” The findings were published in the October issue of Stroke.

Copyright © 2016 HealthDay. All rights reserved.

Brain Stimulation Could Speed Stroke Recovery

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by Charles Q. Choi, Live Science Contributor

For people who’ve had a stroke, a treatment that involves applying an electric current to the brain may help boost recovery of their mobility, a small clinical trial found

Want to see what having a stroke is like?

shutterstock_388523095Sure…every stroke is different. That’s what EVERYBODY says.  Lotje Sodderland suffered a stroke and you can imagine what is is like. When she recalls her hearing becoming distorted, the film’s soundtrack becomes busy and reverberant; when she describes seeing flashes of colour, the screen explodes into a wash of purple and pink. The result feels more like a series of Snapchat filters and echoing karaoke effects than a cohesive glimpse into another person’s perception.

This new Netflix doc uses gaudy special effects to convey the impact of Lotje Sodderland’s stroke, but her story would have been engaging enough on its own

Certain subjects are hard to keep down in the world of documentary. Year after year they resurface, regardless of whether the world really needs another film about the porn industry, mixed martial arts or Kurt Cobain. Most persistent of all is the Inspirational Recovery Story, in which we follow a buoyant character as they rebuild their life in the wake of a tragic incident, often with the aid of music or some kind of alternative therapy. Premiering yesterday as a highly promoted Netflix Original, My Beautiful Broken Brain is the latest entry in that familiar canon, and its overall structure closely follows the formula established by its predecessors, even as its best moments push beyond the genre’s conventions.

Lotje Sodderland was a digital producer at a hip London creative agency when she suffered a stroke that decimated her language skills and threw her sensory perception into disarray. Together with co-director Sophie Robinson, she began documenting her recovery in hundreds of hours of intimate iPhone videos, footage that would ultimately become the bedrock of My Beautiful Broken Brain.

Click on the following link to preview the show:

Like many other films about impaired cognition, the documentary attempts to simulate Lotje’s experience of the world for the audience, transplanting her peculiar window on existence to the big screen. In theory, film should be the perfect medium for such a task: just as a melody is easier to hum than describe, sensory matters lend themselves to an art form that’s all about the senses. In practice, though, the further the movie goes in attempting to bring her viewpoint to life, the less it succeeds.

For example, where The Possibilities Are Endless – another recent documentary about stroke recovery – conveyed a sensory journey through metaphor and inference, My Beautiful Broken Brain opts for an achingly literal translation of Sodderland’s descriptions. When she recalls her hearing becoming distorted, the film’s soundtrack becomes busy and reverberant; when she describes seeing flashes of colour, the screen explodes into a wash of purple and pink. The result feels more like a series of Snapchat filters and echoing karaoke effects than a cohesive glimpse into another person’s perception, although it does validate Sodderland’s claim that she experiences the world like a “David Lynch movie”, if you take her to mean the gaudy music videos that have made up the bulk of Lynch’s output since he unofficially retired from film-making a decade ago.

My Beautiful Broken Brain works best when it allows its subject-cum-author to talk plainly about her situation; despite her linguistic impairment, Sodderland is an engaging and illuminating video diarist. It’s these quiet, intimate moments, and not the trailer-friendly VFX showcases surrounding them, that lift the film above a crowded field of like-minded docs.

 

Am I getting better now?

shutterstock_309537812When I first started writing my Blog, it took me SO MUCH time…and all I could get out were a few sentences.  Do you remember how that felt?  It was like being 5 years old and trying to explain something. And then when I was done,  I had to read it again, a few hours later, to correct the multiple mistakes!
When I began, I started with 1 posting per week…and No graphics.  It was REALLY hard, but I made sure I fulfilled it each week.  Check it out:

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Let’s start the week!

When I first started my Inspiration Speaking business, I was just doing follow up calls on people that I invited to hear me speak.  I had 80 people originally hear the presentation and I was making my follow up calls in between my other job. That was 10 months ago.   Now,  I am meeting people everyday and giving speeches 2-4 times per week!  It’s busy…but I like it that way.

Today, I met a woman who I hope to meet again.  I told her what I was doing and she gave me a few names to call.  She was  fantastic; I can’t wait to call them!  I feel blessed by the people I am meeting. God is looking out for me!

Pretty good, right!  Be honest…I want to get better.  I am open to tips.

Do you speak more than one language? Then that’s good….

A new study conducted by researchers in India has found that individuals who are fluent in more than one language had better protection against cognitive injury as a result of stroke.

After having a stroke, bilingual patients were about twice as likely to have normal brainfunction – 40 percent of bilingual strokepatients had normal brain function, compared to roughly 20 percent of monolingual stroke patients.

Every year, millions of people worldwide suffer from stroke, poor blood flow to the brain resulting in cell death. They also took into account the lifestyle of the participants, including smoking, high blood pressure, diabetes and age. The main risk factor for stroke is hypertension.

Four in 10 bilingual patients made a full recovery following a stroke, compared with just two in 10 among those who spoke only one language, researchers from the University of Edinburgh found.

The study appeared in the American Heart Association journal Stroke.

The authors suggest the protective effect of being bilingual was not because of linguistic skills, but was probably related to “executive functions acquired through a lifelong practice of language switching”.

Both study groups, however, displayed virtually similar rates of aphasia, with monolinguals showing an 11.8 percent frequency for the developing the language disorder and bilinguals showing a 10.5 percent frequency for the condition.

The study, which was published in the journal Stroke, used data from 608 stroke patients in Hyderabad who were assessed, on attention skills and the ability to retrieve and organise information. Bak and Alladi’s earlier research showed that bilingualism may postpone the onset of dementia and improve concentration.

The team previously discovered that people who speak more than one language develop dementia several years than monolinguists.

The findings of the Nizam’s study run contradictory to those suggested in an earlier research carried out by British researchers. Alladi said that bilingualism in Hyderabad may not mirror bilingualism in the United States – fluency in more than one language is common in India, whereas in the United States, it tends to be seen more among recent immigrants and better-educated Americans. “Constantly switching languages is a daily reality for many residents of Hyderabad”, said Suvarna Alladi, lead author of the study, “The cognitive benefit may not be seen in places where the need to function in two or more languages isn’t as extensive”.

However, there was no difference in difficulty with speaking, reading and writing after a stroke.

Interestingly, the researchers found that bilingualism was not associated with better language abilities after a stroke.

It suggests that other activities which boost brain power, such as taking part in night classes, playing chess, doing crosswords, learning an instrument could also prevent the mental decline.

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