Q. What determines how well someone recovers from a stroke?
A. The first factor that influences a person’s recovery from a stroke is the nature of the stroke itself: how much damage occurred in the brain and where. Receiving acute medical attention is important; treating ischemic stroke (the most common form, caused by a blocked blood vessel) with a clot-busting drug shortly after the stroke can reduce its effects.
Randie M. Black-Schaffer, medical director of the Stroke Program at Spaulding Rehabilitation Hospital, says, “some areas of the brain are more forgiving than others.” For example, damage to the primary motor cortex, which controls movement, can sometimes be overcome by redundant areas that take over. The ability of the brain to form new connections and recruit new areas for different functions, called neuroplasticity, can also help.
“That’s where therapy comes in,” she says. Depending on the severity of a stroke, a patient may spend weeks to months in a rehabilitation program, which works to overcome deficits in movement, speech and language, and other functions. Black-Schaffer says that some abilities can improve even years after a stroke, but success depends on a patient’s motivation. For that reason, damage to areas of the brain relating to cognitive awareness, motivation, and attention can make recovery much harder. Age is also a factor, as younger people tend to recover more rapidly.