Introduction to Stroke and the Stroke Care Unit

In most people with ischemic stroke, loss of function is greatest immediately after the event. However, in approximately 15% to 20% of patients, the stroke continues to progress, causing additional functional loss over the next one or two days. This is known as an evolving stroke. In hemorrhagic stroke, function is generally lost progressively over minutes to hours.

Patients usually recover part of the lost function over days to months. Although some brain cells die, others sustain limited injury, recover, and resume function. In addition, some brain areas may assume functions previously performed by the damaged region, a capacity known as neuroplasticity.

However, early effects of stroke, including paralysis, may become permanent. Muscles that are not used regularly may become chronically spastic and stiff, causing painful spasms. The patient may continue to have difficulty walking, swallowing, speaking clearly, or performing activities of daily living. Problems with memory, thinking, attention, learning, and emotional control may persist, as may depression, hearing or visual impairment, and dizziness.