Stroke and the brain: Understanding damage, recovery and healing

Every stroke tells a story of a sudden moment when the brain's lifeline is disrupted, leaving a lasting impact on a person's health and well-being. Stroke is not only one of the leading causes of death in Australia, but also a significant contributor to disability.

To understand stroke, it's essential to look at how it impacts the brain, affecting everything from movement and speech to emotions and memory.

The brain relies on a steady flow of blood to function. A stroke interrupts this flow, cutting off oxygen and nutrients. Without these vital resources, brain cells begin to die within minutes. The type of symptoms and the extent of damage caused by a stroke depends on:

• the type of stroke: Ischaemic (caused by a blood clot), haemorrhagic (caused by bleeding in the brain) or a transient ischaemic attack (a temporary, stroke-like condition which can be a warning sign of a future stroke)
• the location: Which part of the brain is deprived of blood flow
• the duration: How long the brain goes without oxygen.

Each part of the brain has a unique role. A stroke disrupts the functions controlled by the affected area.

1. Frontal lobe: Controls movement, decision-making, and personality. A stroke here may cause weakness, speech difficulties, or emotional or behavioural changes.

2. Parietal lobe: Processes sensory information. Damage can lead to problems with touch, spatial awareness or recognising objects.

3. Temporal lobe: Responsible for memory, hearing and understanding language. A stroke might cause memory loss or difficulty with communication.

4. Occipital lobe: Processes visual information. A stroke here can result in vision loss or trouble recognising objects.

5. Cerebellum: Coordinates balance and movement. A stroke here often causes clumsiness, dizziness or difficulty walking.

6. Brainstem: The control centre for basic life functions like breathing, blood pressure regulation and heart rate. Damage in this area can be life-threatening and may lead to loss of consciousness or even paralysis.

The effects of stroke often extend beyond the physical to include emotional and psychological challenges such as:

• depression and anxiety: Changes in brain chemistry and the emotional toll of recovery can lead to mental health challenges
• personality changes: Damage to specific areas, like the frontal lobe, may result in impulsiveness or emotional outbursts.

Support from mental health professionals and a strong social network can make a big difference in helping someone cope with these challenges.

Cognition is our ability to think, remember and make decisions. A stroke can affect these skills in 3 ways:

• memory loss: Especially if the stroke was in the temporal lobe
• difficulty concentrating: Survivors may find it hard to focus on tasks
• problem-solving issues: Everyday decisions may feel overwhelming.

Rehabilitation often includes seeing a neuropsychologist or occupational therapist, who help survivors develop strategies to manage these changes.

The brain's superpower lies in its neuroplasticity. This refers to the brain's ability to rewire and evolve through new information and challenges.

Post-stroke therapy helps the undamaged parts of the brain to take over the functions of the damaged areas. While recovery varies from person to person, early and consistent rehabilitation can lead to significant improvements over time, even for years after the stroke. For example, a person who initially loses the ability to speak may regain it over time with the help of speech therapy.

If yours or someone else’s life is in danger, dial 000 immediately.

The Stroke Foundation offers comprehensive guides on prevention, treatment and recovery. You can also call StrokeLine on 1800 787 653 for advice and to be connected to services for survivors, family and carers.

Stroke Recovery Association NSW provides information on how depression can affect you after stroke.

The Brain Foundation features a risk self-assessment chart as well as information on long term effects, rehabilitation and recovery, and the latest Australian research papers.

Lifeline Australia offers 24/7 crisis support online and on the phone at 13 11 14.

Beyond Blue offers 24/7 mental health information and support online and on the phone at 1300 224 636.