STROKE-RECOVERY MECHANISMS

SUMMARY

1. Resolution of post-stroke oedema: this process may continue for up to 8 weeks. Cerebral haemorrhages tend to be assoc. with more edema & dramatic recovery.

2. Reperfusion of the ischemic penumbra: a focal ischemic injury consists of a core of low blood flow which eventually infarcts, surrounded by a region of moderate blood flow, the ischemic penumbra, which is at risk of infarction but is still salvageable.

3. Resolution of diaschisis: diaschisis is low reactivity or depressed function in an area that is at a distance from the site of injury, but is connected to it.

4. Cortical reorganization (late recovery): this can extend for a much longer period of time than local processes and is influenced by rehabilitation training. Reacquiring motor skills is associated with functional neurological reorganization occurring in the undamaged cortex.

5. Proportional Recovery of Upper Limb Impairment: within 6 months UL impairment resolves by fixed proportion; 70% of each patient's maximum improvement occurs regardless of the initial impairment for those with an intact corticospinal tract.

Reference(s)

Teasell, R., Hussein, N., Mirkowski, M., Vanderlaan, D., Saikaley, M., Longval, M. and Iruthayarajah, J., 2020. Brain Reorganization, Recovery and Organized Care. [online] Ebrsr.com. Available at: Handbook Chapter 4_Upper Extremity Post Stroke_ML.pdf Ebrsr.com [Accessed 11 November 2020].

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
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