Stroke Care During COVID-19: Are the Brain-Injured Suffering

Stroke care is a complicated and long-winded process, but how has it all been affected during the COVID-19 pandemic? Take a look…

The COVID-19 pandemic has had a huge impact on us as a society. Not only has it affected the way we live and work, it’s had a devastating effect on our economy and our healthcare system.

One of the common examples of medical negligence we have been seeing over this whirlwind of a year so far has been delayed diagnosis and treatment. This could include the delayed treatment of cancer and other severe medical conditions, including stroke.

The question is, what sort of impact will this have on stroke sufferers and survivors? This article hopes to answer this question, providing a rundown of what a stroke is, the treatment and rehabilitation required, and how the pandemic has had a knock-on effect this. Take a look…

What is a Stroke?

Before we dive into what stroke care entails, including treatment and recovery, and how this has altered during the pandemic, what is a stroke?

A stroke occurs when the brain is starved from oxygen due to a blockage or disruption in the blood stream. Here, we’ve listed the signs, symptoms, causes and types, so you can understand its severity a little better.

Types of Stroke

There are two main types of strokes that your body might suffer from. These are:

• Ischaemic: where a blood clot within your system cuts off blood supply to the brain. This occurs in about 85 percent of cases.
• Haemorrhagic: this occurs when a weakened blood vessel supplying oxygen to the brain bursts.

Alongside these types, there also exists what’s known as a “mini-stroke”. This is a transient ischaemic attack (TIA), and is the same as an Ischaemic stroke, except the symptoms only last for a short period of time. This can occur if the blockage to the brain is only temporary, and soon passes.

Symptoms of a Stroke

Anyone who has studied First Aid will know the sure signs of a stroke. These can be remembered using the handy acronym, FAST. These stand for:

• Face: your face may droop on one side, which might cause the eye or mouth to drop, and possibly making the person unable to smile properly.
• Arms: a stroke might cause the victim to be unable to life one or both of their arms. If the arms are weak or numb, this is a cause for concern.
• Speech: if the person is unable to speak properly – perhaps their speech is slurred or jumbled – this is a sure sign. They may also have trouble understanding what you’re saying to them.
• Time: if you notice any of the above signs, it’s time to call 999 immediately.

Alongside these classic symptoms, you might also feel a sense of paralysis, numbness or weakness in the legs, confusion, blurred vision, loss of balance and co-ordination, a sudden severe headache, and trouble walking.

What is the Treatment for a Stroke?

After a person suffers a stroke, they will need intensive hospital care to get them back on their feet. It depends on what type of stroke you have and what part of the brain was affected.

That said, first and foremost, your doctor will administer blood thinning medication to reduce blood pressure and cholesterol levels. This medication should also help to dissolve and prevent further blood clots.

In extreme cases, a procedure to remove the blood clot might be necessary. This is usually done through keyhole surgery, but may require invasive surgery to reduce further bleeding and swelling in the brain.

Rehabilitation After a Stroke

It’s not just initial treatment that needs addressing. In fact, after a person survives a stroke, this is really only the beginning.

The journey to recovery – or as much recovered as a person can become – won’t be easy. Strokes can cause long-term damage to the individual’s nervous system, speech, movement, and brain function.

Because of this, a person will require medication and rehabilitation to combat the symptoms post-stroke. Some of the long-term medication a stroke survivor might need include pills, patches or physical therapy to deal with:

• Excessive salivary gland production to combat drooling and difficulty swallowing
• Dry mouth
• Depression and anxiety
• Seizures
• Spasticity
• Thinning the blood, thus preventing another stroke
• Relearning basic motor function skills, like gripping and walking

This ongoing care means a person who has survived a stroke must remain in hospital for a time afterwards. They must also return for check-ups, physical therapy, and perhaps even to join a support group.

How is Stroke Care Doing Throughout COVID-19?

Considering the amount of support a stroke survivor requires, both immediately after the stroke and during recovery, it’s clear that a fair bit of hospital care is required. That said, the strain that COVID-19 is having on NHS workers is putting real pressure on the system. Now, delayed diagnosis and treatment has become part and parcel of healthcare these days.

It’s thought that the ramifications of COVID-19, particularly on cancer patients, will be devastating. So, it wouldn’t be wrong to assume that we could be looking at the same picture for stroke sufferers. Let’s take a look…

Initial Care

A report in the European of Neurology has said that the entire system had to be reorganised to deal with the new influx of COVID patients. As resources, facilities and staff were required for these new patients, stroke care was initially centralised to a number of limited centres.

This meant access to stroke diagnostics and time‐dependent therapies was limited or delayed. That said, as initial stroke care is extremely urgent – a life or death situation – this emergency care hasn’t been affected.

Rehabilitation

The same can’t be said for rehabilitation, and general long-term care and therapy. Less staff available on the wards means more pressure on those who are in the front-line of stroke care.

What’s more, the risk of infection for those in the hospital throughout the pandemic has meant patients are being discharged quicker than normal.

Some have argued that the pandemic has spurred further research and change that would’ve occurred at a slower rate pre-pandemic. That said, because stroke care after the initial treatment isn’t as urgent as more life-threatening illnesses, long-term care has suffered. 

What Does the Future of Stroke Care Look Like Post-COVID?

As you can see, the healthcare sector has had to adapt and change immensely due to the pressures they’ve faced during the Coronavirus. Although it’s really too soon to tell how the pandemic has affected stroke care, we can assume that it could have a long-term effect on it. After all, the back-up of patients for all non-COVID illnesses is exponentially increasing.

Ultimately, it’s thought that the indirect effects of COVID-19, as we’ve seen above, may negate the efforts of neurologists over the past few years to reduce stroke mortality rates. Although efforts are certainly being made by experts in the field to combat these problems, we can predict that the long-term impacts of COVID-19 on the healthcare system could be devastating.