Dear Readers,

Welcome to NeuroAiD's June 2009 Newsletter. The idea of this monthly release is to share vital information for stroke patients and their families, and help them deal successfully with the common challenges life presents after a stroke.

This month, we are going to talk about a learning disability after a stroke describing difficulties with written language and reading, the dyslexia, and its rehabilitation. Secondly, we would like to focus on how Post Traumatic Stress Disorder, originally considered a wartime soldier’s mental disease, can be caused after a stroke, and what kind of therapy can help in this case. At last, let us have a look in the emergency room and learn how should we react, if one patient complaints that he/she feels dizzy – as this may be linked to a dangerous stroke.

We want this to be more than a one-way communication, and would be most happy to hear back from you. What you have experienced and learned will be very valuable to others and we will make sure it reaches as many people in our community as possible. Do also let us know what topics you wish to read in future issues of your NeuroAiD's newsletter.

We would like to assist you in your return to daily life while recovering from stroke. As you are probably already aware, making the best use of time is of vital importance in your stroke recovery. Therefore, please allow us to call you at a number, day and time of your convenience, to hear your questions and explain our answers. If you agree, kindly email us the table below at info@neuroaid.com :

• Number :
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If you choose to contact us yourself instead, call us on our US toll free number: 1-800-882-4046 / +65-6478-9430 or email us at info@neuroaid.com

The NeuroAiD™ Team at Moleac

The benefits of reading are tremendous. It relaxes, providing stress relief. It stimulates the brain while stretching the imagination in new directions through others’ stories. Reading is as well a great mean of entertainment and especially of getting more knowledge. It is like exercising and getting both mental and physical benefits.

Dyslexia is a learning disability that manifests itself primarily as a difficulty with written language, particularly with reading. Unfortunately stroke often produces this disorder. This “acquired dyslexia” or alexia may occur with or without other language challenges and even when the writing ability is intact.

Stroke can cause different types of dyslexia and its variety reflects actually two things: 1) the way normal reading ability is organized in the brain, and 2) the size and location of an individual stroke. Our brain’s left hemisphere supports most language functions, and the right hemisphere does support some normal reading abilities. As described, a person with a left hemisphere stroke can regain some reading ability via recovering the injured left hemisphere as well as resorting to the right healthy one.

Silent reading can be easier than reading aloud. The reason is simple : Pronunciation of a word is linked to a lingering challenge for nearly all stroke patients, and this difficulty in recalling how to pronounce words has big impact in reading aloud as well as in the conversational skills. On the other hand, some patients have a hard time recognizing written words as icons.

There are some ways around the reading block. In order to compensate, many people use audio tape resources as Books on Tape: Classics as well as instructional materials for hobbies and interests are available on audiotapes and videotapes, and current technology lets computers scan texts and read them out loud for patients.

For these people, it will be useful pairing a written word with the corresponding picture, which may help to recognize the icon of the word, and understanding and or associating its meaning. Here below are some examples of how to practice:

• Read magazine or newspaper headlines and look at the associated pictures.
• Surf the Internet for Web pages where words and pictures are paired.
• Watch television with subtitles on the bottom of the screen.
• Listen to an audiotape while looking at the corresponding written words.

The above tasks require only silent reading, not reading aloud, and can effectively help patients to better understand what they read.

Some other people with acquired dyslexia have difficulty reading sentences or paragraphs because they don’t manage to focus their visual attention on one word at a time. This deficit can be reduced by cutting a “window” in a piece of paper, and the user would move the “window” along a line of text so that only one word can be read or seen at a time.

These strategies and exercises can help survivors with dyslexia to improve their reading ability after a stroke. Patients should not forget to see a speech-language pathologist. Treatment often helps. Most of the speech-language pathologists are specifically trained to know how to diagnose acquired dyslexia, and can therefore recommend treatment or appropriate home-practice strategies according to each person’s unique pattern of dyslexia. However, the process of reading recovery is complex and largely depends on the location and severity of the stroke.

 

Sources:

American stroke association

Post Traumatic Stress Disorder (PTSD) is originally considered a wartime soldier’s disorder and is so far limited to those who have experienced an intense life and death trauma of war like battle fatigue.  Nowadays PTSD is a type of anxiety disorder which can occur in people who have gone through a severe and traumatic physical or emotional event. Relatively new to the family of Anxiety Disorders, PTSD was added to the Diagnostic and Statistical Manual III by the American Psychiatric Association in 1980.

PTSD actually includes repeated recollections of the traumatic event through flashbacks and dreams. These flashbacks are details like the images, sounds, smells, etc, associated with the traumatic event in which the victims re-experience the feeling of horror. It may start with the following symptoms:

• Depression
• Sleep problems, nightmares
• Emotional numbing, feelings of detachment
• Social withdrawal
• Difficulty concentrating
• Hostility
• Being easily startled
• Loss of interest in previously enjoyable activities

As we explained before, a stroke, or a brain attack, is caused by bleeding inside the head or sudden loss of blood to the brain. Due to the death of brain cells, a stroke survivor may develop paralysis, loss of feeling, speech problems or memory loss and reasoning problems. These damages left by a stroke might also cause emotional problems such as depression and anxiety. After a stroke, many things may remind stroke survivors of the feelings they experienced during their stroke, or they may have recurrent unwanted thoughts and memories about the stroke they can not get rid of, even when they try to avoid thinking about it.

A study carried in the UK last year, and published in Neurosurgery recently, found that more than 30% of stroke survivors – similar proportion as those returning home from a war zone – had classic PTSD symptoms. These included feeling anxious all the time, having bad memories or nightmares and physical symptoms such as headaches. Scientists pointed out that some survivors may be in reality thinking they were about to have another stroke, even though there was practically no chance of that happening. As a consequence, some of them were having sleeping and social problems. PTSD is especially common after subarachnoid hemorrhage as it is usually brought on by a sudden, unexpected event. No doubt, PTSD and its symptoms can prevent patients from making a full recovery.

The study suggested that regular testing and treating PTSD could greatly improve the recovery of stroke victims.

What are the treatment options for PTSD sufferers? Many forms of therapy are used. However, the most researched, clinically proven, and recommended form of treatment therapy for PTSD is Cognitive Behavioral Therapy (CBT). CBT is a structured, short-term therapy and is very goal-oriented. This treatment teaches PTSD sufferers to understand and change their thinking patterns so they can change their behavior and emotional state, to think and respond differently in situations that cause anxiety.

If you had a stroke and it was a frightening event that still bothers you, it might be worthwhile to talk with your doctor about being evaluated to see whether you have an anxiety problem, such as PTSD. Mention the symptoms you are noticing. You do not have to tell your doctor the details of the trauma if you are uncomfortable talking about it. Your doctor will be able to refer you to a mental health provider who can do an assessment and help with treatment options. If you have a PTSD, treatment will make a big difference in your life and recovery from stroke.

Sources:

Mailonline – Health

Neurology Journal

Dizziness is an uncomfortable inner feeling of confusion. This word is used to describe many different sensations. When a patient in the emergency room announces that he/she is feeling “Dizzy”, doctors should figure out exactly what this person means by the word “dizzy”. It might be difficult to find out the cause of a person’s symptoms. Some people will say that they are dizzy when they are light headed and nauseous; while others will say they are dizzy when they feel anxious, have low blood sugar or experience double vision. Yet others will say that they are dizzy because they have a feeling that the world is spinning around them, like vertigo.

Is the dizziness vertiginous or not? This is a basic question that we spend considerable time trying to figure out. Vertigo is a specific spinning sensation, an illusion of your motion. If you watch a person look out of the window in a train or car, as they move past telephone poles or trees, they see a repeat jumping eye movement. The eye slowly goes in one direction and quickly back to its original position in the opposite direction. This is what we call “nystagmus”, it goes with vertigo. For many people, vertigo is worse when they move or stay in a particular position. Nausea and vomiting often accompany severe vertigo.

What does this have to do with stroke? Many conditions can make lightheaded, nauseous or anxious, but out of many conditions that can cause people to feel vertiginous, stroke is one of the most dangerous ones, especially a brainstem stroke, which is a stroke originated in the brain stem – the part of the brain where many of the body’s basic life support functions is handled, such as breathing and heart rate. Hence, a brainstem stroke can be fatal. The symptoms of a stroke are different depending on where in the brain the stroke is located. However, in the case of a brainstem stroke, the patient often experiences vertigo, which makes it really important, while hearing him or her say “I feel dizzy” in the emergency room, that the physician makes sure this person is not actually feeling vertigo. Otherwise this would suggest that the symptom might be caused by a dangerous brainstem stroke that is occurring right then.

A handful of treatments are available for brainstem strokes, but for these treatments to be effective they have to be implemented rapidly after a person first notices their symptoms.

Sources:

eMedicine Neurology

Stroke.about.com

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