Prognosis and Recovery

People often want to know when their loved one will get better and how much the person will recover. These are very difficult questions to answer because of many uncertainties about strokes.

Your health care team will do their best to provide you with the most accurate estimation of recovery that they can. Sometimes, however, the most honest response will be a frustrating one: “We’ll just have to wait and see.”

Many factors affect the rate and extent of recovery after stroke. Your loved one’s physicians will be collecting and integrating all the information available as they make their assessments. Some of these factors include:

  • Age at the time of the stroke
  • Severity of the stroke
  • Location of the stroke
  • Personality before the stroke
  • Environment since the stroke
  • Motivation for recovery
  • Family support
  • Physical ability before the stroke

The Recovery Process

The fact that the brain recovers at all is remarkable in many ways. A stroke causes the death of brain cells (neurons).

Unfortunately, the brain is one of the few places in the body that cells do not seem to regenerate. Yet, people with stroke often make tremendous gains. Scientists are still unsure about all of the mechanisms that allow for brain recovery. Possibilities include:

  • Other parts of the brain take over the functions of the damaged areas.
  • New connections between the remaining brain cells may form.

People can get better after stroke. However, for the reasons mentioned, predicting the degree and pace of recovery is very difficult.

Much of the recovery after a stroke occurs early, usually within the first six months. Most experts agree that the brain can continue to heal for up to two years afterward. Even after two years, people can continue to slowly improve. The reason for this continued progress is that many of the gains after the first year or two do not depend so much on the healing of the brain, but on the learning of new skills.

Although difficulties, such as muscle weakness or poor memory, may not change at this point, people who are recovering are learning ways to compensate and become more functional. The recovery process at this point is more like being back in school than recuperating from a surgery.

Complications to Watch Out For

  • Dehydration
  • High Blood Pressure
  • Urinary Tract Infections
  • Clinical Depression
  • Mental Status Change
  • Fever
  • Pneumonia
  • Deep-Vein Thrombophlebitis (DVT)
  • Pulmonary Embolism (PE)
  • Seizure