A Presenter's Struggle: Andrew Marr's Stroke Recovery
A presenter named Andrew Marr, 53, suffered a severe stroke two years ago after rupturing his carotid artery during a strenuous rowing workout. Prior to the stroke, he continued to exercise regularly and had no history of high blood pressure. After the stroke, he needed months to recuperate, and two years later, he is still attending physiotherapy sessions. He goes to four physical therapy sessions each week. Even while his recovery has made progress, Andrew still walks with a severe limp and needs to wear a splint to support his legs. His left arm is hardly even usable. Andrew's case is an ischaemic stroke caused by a carotid artery dissection/tear. An ischaemic stroke is basically caused by a blockage that cuts off blood supply to the brain. Ischaemic strokes are the most common type of stroke (the other being haemorrhagic stroke) causing over 80 percent of all strokes (Swain, Turner, Tyrrell and Rudd, 2008).
The Carotid Artery Tear and Clot Formation
In this case, one of the four carotid arteries found in the neck which transports blood to the brain, eyes, and facial structures tore. Formation of a blood clot after subsequent leaking from the carotid artery tear effectively limited blood flow through the artery. The ischaemic stroke resulted after the clot became large enough to completely block the flow of blood to the brain. The symptoms of an ischaemic stroke, like any other stroke, depend on the side of the brain that is affected, the part of the brain affected, and the severity of the brain injury. The most common indicator of ischaemic stroke is a sudden weakness of the face, arm, or leg. In most cases, the weakness is on one side of the body. Other warning signs include the following: sudden confusion and trouble speaking or understanding speech, sudden trouble seeing in either one or both eyes, and sudden trouble walking (The New Jersey Comprehensive Stroke Center at University Hospital, 2013).
Diagnosis and Treatment
A stroke is a medical emergency and recovery is dependent on how quick the stroke is diagnosed and treated. Diagnosis is usually made using a brain scan. A magnetic resonance imaging (MRI) scan or a computed tomography (CT) scan will show whether the stroke has been caused by a blockage or by something else entirely (Stroke Association, 2015). Diagnosis of the right type of stroke is important since treatment for each type of stroke is significantly different. Treating an ischaemic stroke as though it were a haemorrhagic stroke or vice versa could have consequences that are life-threatening to the patient. As such, in Andrew's case, the results of the brain scan would influence the treatment of the stroke.
Since Andrew's stroke was caused by a blood clot after carotid artery dissection, the appropriate treatment is through clot-busting medicine. The process of breaking down and dispersing a clot that is preventing blood flow to the brain is known as thrombolysis. The clot-busting medicine must be administered within four and a half hours of the advent of stroke symptoms for it to have the best effect. The administration of anti-platelet medication would also prevent Andrew's blood from clotting. Throughout the recovery period, follow-up, and imaging studies of the carotid arteries are necessary.
Identifying Risk Factors and Long-Term Recovery
There are a couple of health risk factors that increase the chances of someone getting a stroke. They include prior stroke, prior heart attack, high blood pressure, unhealthy cholesterol levels, structural heart problems, atrial fibrillation, carotid artery disease, and peripheral artery disease (Swain et al., 2008). The most obvious risk factor in Andrew's case was carotid artery dissection as a result of hyperextension of the neck. This was ultimately the cause of the stroke in this case.
Andrew Marr has endured the consequences of stroke which are still apparent two years after the major stroke. The type of disability observed in his case is paralysis or problems controlling movement. The paralysis basically occurs on the opposite side of the body from the side of the brain damage. The paralysis on Andrew's left hand is an indication that the damage was on the right side of the brain. A stroke is an emotionally challenging event both for the patient and their families. Andrew could no longer do things as comfortably as he did before, which is very frustrating. A man who was physically fit and healthy has now been reduced to using a splint to work and can barely use his left hand. According to research, stroke patients do best when their caregivers and families are encouraging and supportive. The efforts of Andrew's wife are therefore very influential in his recovery. As regards long-term recovery, it is important to realize that stroke affects everybody differently. As such, Andrew's condition may continue over a long which based on the current situation could be another couple of years. Good care and rehabilitation in physical, social, and emotional aspects are necessary for eventual recovery.
References
The New Jersey Comprehensive Stroke Center at University Hospital, 2013. Types of Stroke. Available from: http://www.uhnj.org/stroke/types.htm. [3 March 2017].
Stroke Association, 2015. Ischaemic Stroke. Available from: https://www.stroke.org.uk/what-stroke/what-stroke/ischaemic-stroke. [3 March 2017].
Swain, S., Turner, C., Tyrrell, P., Rudd, A., on behalf of the Guideline Development Group, 2008. Diagnosis and initial management of acute stroke and transient ischaemic attack: summary of NICE guidance. BMJ 337, a786–a786. doi:10.1136/bmj.a786
