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Theme IV: Post Stroke Repair and Recovery
Restoring brain function
Sixty per cent of stroke patients are left with a permanent disability. The impact on quality of life is enormous – both for stroke patients and their families. The good news is that the brain is optimally wired for repair. It has efficient mechanisms to heal itself, all aimed at preserving life and improving its quality. Clinicians have always marvelled at the fact that the most common type of stroke leaves the patient with a rigid extended leg, and a flexed arm. This allows the patient to use the leg as a stiff “stick” to walk with, and the arm, bent at the elbow, to eat with by bringing it thus closer to the mouth. Think if, as a result of the stroke, the leg was bent and the arm was stretched, how impossible survival would be.
The other common observation is that stroke patients regain some of the functions lost early. This recovery process is due to the brain “re-wiring” itself. If the part of the brain that moves the right arm is damaged by a stroke, there is initial paralysis of the arm. The brain then assigns the job of moving the arm to an adjacent brain segment that previously had a different assignment, and over time, the arm starts to move again. Reservoirs of young cells (stem cells) have recently been discovered in adult humans. As a result of a stroke, these cells are mobilized out of their hiding places and directed to go towards the site of injury to get involved in the re-building process.