Massive Stroke: Recovery Timeline & Prognosis

This lesson covers massive strokes. We’ll discuss details of the prognosis, including factors that affect the prognosis. We’ll also describe what recovery looks like after a massive stroke.

Definition of a Massive Stroke

Have you ever seen a dam, canyon, or waterfall? You probably thought it looked pretty cool. Some time later, you took a trip and saw the Hoover Dam, the Grand Canyon, or Niagara Falls. Upon seeing them, if you had to put your thoughts into one word, it would probably be massive. All of these places are very huge, or massive. It almost seems like too much to take in.

Conditions that happen in the body can also be of a ‘huge’ magnitude, especially in comparison to smaller versions of the same condition. There are some strokes that are massive. A massive stroke is a loss of oxygenated blood supply to the brain that causes severe brain tissue death and/or damage. It’s massive due to the amount of the area of the brain affected and the extent of damage done. The massiveness of a stroke of this magnitude often prompts questions about the possibility of ever recovering from it. People almost immediately ask about the prognosis for a loved one who has suffered a massive stroke.

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Prognosis for a Massive Stroke

The prognosis, or long-term outlook, for a person who has a massive stroke relies very heavily on a couple of questions that are intertwined. First, how long did the brain go without a supply of oxygenated blood? Second, how severe was the massive stroke? The longer the brain went without oxygen, the worse the prognosis. The more severe the massive stroke, the worse the prognosis. This is because the longer the brain goes without oxygen, the more severe the brain damage and brain tissue death will be.

The other determining factor is the cause of the massive stroke. Some massive strokes known as massive ischemic strokes are caused by a blood clot in an artery of the brain. The blood clot could be a thrombus, which is a stationary blood clot, or an embolus, which is a blood clot in the bloodstream. Other strokes, called massive hemorrhagic strokes, are caused by the leaking or rupture of blood vessels in the brain. The prognosis is better for ischemic strokes versus hemorrhagic strokes, largely due to complications that tend to develop after hemorrhagic strokes.

As you may have gathered by now, there isn’t a set prognosis for massive strokes. However, there are some trends. Less than 50% of people who have a massive stroke will survive for five years, with less than 10% being survivors of massive hemorrhagic strokes. Almost all survivors will have varying levels of disability that is either physical, cognitive, or functional in nature. The other factor impacting the prognosis is that having a massive stroke increases the chances of having another massive stroke or a heart attack.

Recovery from a Massive Stroke

Those that do survive will start the road to recovery, which is very long and often lifelong. Massive strokes normally require several medicines and other therapies. The recovery process is going to include taking medicines that keep the blood from clotting to help prevent future strokes and/or heart attacks.

Physical therapy will be required in order to get the body back to moving as it should and to strengthen the muscles. The muscle movement during physical therapy moves blood through the body as well, which also diminishes the likelihood of blood clot formation.

Occupational therapy will also be a part of recovery. This will help restore functioning so that these individuals can continue or resume caring for themselves. It is very common for stroke survivors to not be able to perform routine daily functions after having a stroke, such as cooking, cleaning, feeding themselves, and bathing. This therapy will focus on coordination to complete these tasks.

Working with a speech therapist and language pathologist will be additional requirements if the ability to speak has been altered by the massive stroke. Speech therapy will help to restore speech, and the language pathologist will help to comprehend verbal communication.

Lastly, seeing a psychologist may be necessary if the emotional centers in the brain were affected by the stroke or if survivors are not able to deal with the tremendous changes that take place in their lives after a massive stroke. They will help them to cope with the mood swings that happen when the emotional centers are damaged.

Lesson Summary

We looked at two questions that are often of concern after suffering a massive stroke. Here is what you should now know:

  • A massive stroke is a loss of oxygenated blood supply to the brain that causes severe brain tissue death and/or damage.
  • The three things that determine the prognosis for a massive stroke are:
    • The amount of time the brain went without a supply of oxygenated blood
    • The severity of damage to the brain
    • The type of massive stroke
  • Massive ischemic strokes are strokes caused by a blood clot in an artery of the brain
  • Massive hemorrhagic strokes are strokes caused by the leaking or rupture of blood vessels in the brain

Less than 50% of people who have a massive stroke survive for five years, with less than 10% being survivors of massive hemorrhagic strokes. Almost all survivors have some level of disability. Recovery is a long period of time, often years or lifelong. It will include physical therapy to get the body back to moving as it should and strengthen muscles, occupational therapy to restore functioning so that survivors can continue or resume caring for themselves, speech therapy and working with a language pathologist to help them to speak and comprehend verbal communication, and psychotherapy to deal with emotional issues.


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