Stroke

Balance

Is the patient experiencing dizziness or loss of balance?

Eyes

Is the patient experiencing vision loss or double vision?

Face

Is the patient's face drooping or numb on one side?

Arm

Is the patient having weakness on one side of the body?

Speech

Is the patient experiencing difficulty in speaking or forming words?

Time

Immediately seek help by calling 9-1-1 and getting the patient to an Emergency Department.

CHA is a primary stroke center, and we offer standard treatment for all patients who come to us with stroke symptoms.

When a patient comes to us with stroke symptoms in the emergency room, after a quick initial evaluation, they are taken to get a CT scan of their head to understand what kind of a stroke they are having. If they are experiencing a stroke from loss of blood supply to a part of the brain, then we immediately contact our affiliate Beth Israel, Deaconess medical center. Within minutes, a stroke trained neurologist is available by video call to evaluate the patient, and make recommendations regarding immediate treatments, which include intravenous clot dissolving medications. If the patient is found to have a large vessel occlusion in one of the arteries supplying the brain, then we urgently transfer them to Beth Israel Deaconess Medical Center, so that they can be evaluated for surgical intervention (clot removal), which has been shown to greatly improve outcome in this patient population.

If a patient is not Transferred to a hospital with advanced services, we routinely admit Stroke patients to our inpatient medicine service. CHA staff Neurologists are available to advise regarding patient care 24/7 after admission, and evaluate them in a timely manner. Patients are tested for cardiac and other risk factors that may have led to their stroke. Usually they are started on medications in the emergency room that are continued during their stay.

Once a patient is considered medically stable, our physical therapists begin to evaluate them and determine what treatments will provide patients with the ability to keep or work toward their usual level of activity.

At the time of discharge, the patient receives a follow up appointment with the neurologist who has been involved in their care, typically in a 4 to 6 week timeframe. At this visit, the neurologist who saw the patient while they were admitted, goes over the recovery process as well as medications that they have been taking. After this point a stroke patient continues to follow up with their neurologist every 3 to 6 months, and are referred to cardiologist and other specialist as needed. 

Physical Therapy After Having a Stroke

Physical therapy (PT) begins very soon after a stroke, most often while you are still in the hospital. It is very important to begin PT as soon as it is safe. Rehabilitation activities, such as exercising, help the brain in making new connections in the healthy parts of your brain. The sooner this work can begin, the better!

Your physical therapist’s main goal is to help you return to your activities at home, work, and in your community.

What to expect: After doing an exam your physical therapist will develop a treatment plan specific to your needs, physical condition, and goals. They will work with you to help you achieve the best possible quality of life.

Once you leave the hospital, therapy appointments can take place at any of the following locations:

• Acute care and rehab hospitals
• Subacute facilities
• Long-term care facilities
• Outpatient rehab facilities
• In the home by home health agencies

The benefits of physical activity on stroke recovery are many and may include:

• Improved overall recovery
• Improved mobility, walking, balance
• Improved mood and help with  depression)
• Reduced risk of stroke recurrence
• Reduced risk of heart-related conditions by reducing blood pressure, obesity
• Reduced risk of falls

Speech Language Pathologists (SLPs) play a significant role in the screening, management, and rehabilitation of stroke survivors who have difficulty swallowing and/or trouble with speaking. Early diagnosis and referral to SLP is critical to making sure the stroke survivor can return to their best level of function. The SLP is also responsible for educating caregivers in strategies that can support the patient and for making appropriate modifications in their day to day life (for example recommending different types of food or providing information in an easy to understand way) to help with the stroke survivor's ability to participate.

What to expect for swallowing:
Your SLP will assess swallowing in people after stroke if difficulty in swallowing is present. The SLP will provide caregiver education on how they can help someone who is coughing or choking while eating or drinking. If the person has trouble swallowing and is unable to take pills, your SLP will help the team find ways to change how medication may be given. In treatment with your SLP, they will help you to eat and drink as safely as possible. Some ways safety while eating and drinking are helped are by making changes to your physical position, changing how you drink fluids for example, taking small sips or drinking thickened fluids), or changing your diet (for example, changing the texture of the food).

What to expect for communication:
Your SLP will work with the stroke survivor to provide therapy for specific communication difficulties, including people that are not able to speak, have trouble making words or sounds, and understanding or speaking what they are thinking. Some of the areas your SLP might work on include helping people after stroke to use and improve their language and speaking, helping to teach other ways to connect with other people, such as gestures or writing. They can provide stroke survivors for other ways to connect with others using pictures and communication boards. They can also help those people around the person after a stroke to support communication skills to help a person's communication be the best it can be, and support people with communication difficulties to rebuild their identity and use information that enables decision making.