Neurological injuries such as atherosclerosis, arterial obstruction, and arterial haemorrhaging all reduce circulation to the brain and can result in brain damage. They can potentially cause permanent disability or even death. Risk factors for such injuries include aging, and health conditions such as high blood pressure, high cholesterol, obesity, smoking and stress. Patients who receive immediate treatment for their injury can make a full recovery. These treatments can restore optimized brain circulation, and are likely to involve intravenous administration of medication to help break down the blockage, or surgery to remove the plaque or clot that is causing the arterial obstruction.
However, despite receiving timely treatment, some patients may still be left with symptoms that require special aftercare or physical therapy as a form of rehabilitation in order to improve the chance for recovery.
Despite receiving stabilizing treatment, some patients may still suffer from problems with movement, independence, eating and communication. Preparations must be made for these patients, their caregivers and their surrounding environment to ensure the best possible recovery. Such preparations include:
1. Disease education, including relevant information and recommendations regarding neurological injuries, to be delivered by doctors prior to the patient’s return home. This information is crucial for understanding potential recovery times, and as a form of protection against repeat injuries. The advice encompasses medication recommendations, strict adherence to a physiotherapy regimen, avoidance of numerous risk factors, and maintaining a positive frame of mind throughout the recovery. Therefore, patients and their caregivers must have a clear understanding of brain injuries and the effects they are bound to leave behind.
2. General care advice for patients, including:
– Diet – Patients should avoid salty foods or meals that contain a lot of salt, as salt is a major cause of high blood pressure. Eating starchy or overly sweet foods affects the body’s ability to manage glucose levels, while fatty foods are a factor behind high cholesterol. All of these can increase the chances of a repeat brain injury. In cases where patients are unable to consume meals orally, medical staff will utilize a feeding tube capable of delivering blended meals and liquids in the appropriate quantities.
– Independence levels – Patients lacking a full range of movement, such as bed-ridden patients, patients unable to sit up independently, and users of walking sticks or wheelchairs, each require varying degrees of assistance. This means modifying the home to suit their needs, including the removal of any obstacles from walkways and being careful to ensure even floor surfaces.
– Communication – some patients may suffer from symptoms related to speech. Their caregivers must exercise patience and understanding when communicating. The mental wellbeing of patients should also be attended to as they may experience anxiety that can lead to insomnia or depression.
3. Keeping an eye out for any irregularities that necessitate medical attention outside of patients’ usual appointment times, such as headaches, dizziness, muscle weakness, an increase in speech difficulties, high or low blood pressure, rapid breathing and phlegm discoloration.
4. Preparing patients for their follow-up appointments by ensuring they fast from all food and drink for the appropriate time period, keeping count of any remaining medication, and informing medical staff of any issues that may have occurred at home.
5. Learning the proper use of special equipment used to track and record vital signs, including blood pressure and blood glucose monitors. This data will assist medical staff at the patient’s next appointment.
6. Ensuring caregivers are prepared and undergo any required aftercare training, especially in cases where the patient is unable to carry out tasks independently. Should potential caregivers have any concerns about providing treatment, they might consider our Stroke TeleCare services, which include home care programs designed for disabled and incapacitated patients delivered by a team of doctors, nurses and physiotherapists promptly available via videocall 24 hours a day.
The most effective protection against further brain injuries is to avoid potential risk factors and to be aware of the danger signs associated with them, such as numbness or weakness in the facial muscles, arms and legs, complete numbness down one side of the body, a drooping mouth, staggering, and balance problems. If the patient experiences any of these symptoms, however sporadically, medical attention should be sought immediately.
For patients who have received treatment for a neurological injury, repeat occurrences should be avoided at all costs. Any subsequent injury could be fatal. Therefore, consulting medical staff and strictly adhering to their advice after returning home provides a great chance to make a full recovery from a neurological deficit.
The Second Class Honors, M.D., Faculty of Medicine, Mahidol University, 2008 Faculty of Medicine Siriraj Hospital, Mahidol University , 2008