Symptoms. Risk Factors

Transcription

1 The following excerpt has been taken from the Christopher & Dana Reeve Foundation Paralysis Resource Center website. Stroke A stroke occurs when the blood supply to part of the brain is suddenly blocked or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. In the same way that a person suffering a loss of blood flow to the heart is said to be having a heart attack, a person with a loss of blood flow to the brain or sudden bleeding in the brain can be said to be having a "brain attack." Paralysis is a common feature of stroke, often on one side of the body (hemiplegia). The paralysis or weakness may affect only the face, an arm, or a leg or may affect one entire side of the body and face. A person who suffers a stroke in the left hemisphere of the brain will show right-sided paralysis or paresis. Conversely, a person with a stroke in the right hemisphere of the brain will show deficits on the left side of the body. Ischemia is the term used to describe the loss of oxygen and nutrients for brain cells when there is inadequate blood flow. Ischemia ultimately leads to infarction, the death of brain cells, which are eventually replaced by a fluid-filled cavity (or infarct) in the injured brain. When blood flow to the brain is interrupted, some brain cells die immediately; others remain at risk for death. The damaged cells can be saved by early intervention with drugs. Researchers have learned that restoring blood flow to these cells can be achieved by administrating the clot-dissolving agent tissue plasminogen activator (t-pa) within 3 hours of the start of the stroke. Many neuroprotective drugs are being tested to prevent the wave of damage after the initial attack. Stroke has always been viewed as unpreventable and untreatable. Added to this fatalism was the wrong belief that stroke happens only to the elderly and is therefore not of concern.

2 As a result of these misconceptions, the average stroke patient waits more than 12 hours before arriving at the emergency room. Health care providers take an attitude of "watchful waiting" instead of treating stroke as a medical emergency. With the use of the term "brain attack," stroke has a definitive, descriptive name. The appropriate response to a brain attack is emergency action, both by the person it strikes and the medical community. Educating the public to treat stroke as a brain attack and to seek emergency treatment is crucial because every minute lost, from the onset of symptoms to the time of emergency contact, cuts into the limited window of opportunity for intervention. Symptoms The symptoms of a stroke are easy to spot: sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause. Stroke can usually be distinguished from other causes of dizziness or headache. These symptoms may indicate that a stroke has occurred and that medical attention is needed immediately. Risk Factors The most important risk factors for stroke are hypertension, heart disease, diabetes, and cigarette smoking. Others include heavy alcohol consumption, high blood cholesterol levels, illicit drug use, and genetic or congenital conditions, particularly vascular abnormalities. Early Recovery In ways not clearly understood, the brain compensates for the damage caused by stroke or brain attack. Some brain cells may be only temporarily damaged, not killed, and may resume functioning. In some cases, the brain can reorganize its own functioning. Sometimes, a region of the brain takes over for a region damaged by the stroke. Stroke survivors sometimes experience remarkable and unanticipated recoveries that can't be explained. General recovery guidelines show: 10 percent of stroke survivors recover almost completely 25 percent recover with minor impairments 40 percent experience moderate to severe impairments requiring special care 10 percent require care in a nursing home or other long-term care facility 15 percent die shortly after the stroke

3 Rehabilitation Rehabilitation starts in the hospital as soon as possible after the stroke. In patients who are stable, rehabilitation may begin within two days after the stroke has occurred, and should be continued as necessary after release from the hospital. Rehabilitation options may include the rehab unit of a hospital, a subacute care unit, a rehab hospital, home therapy, outpatient care, or long term care in a nursing facility. The goal in rehabilitation is to improve function so that the stroke survivor can become as independent as possible. This must be accomplished in a way that preserves dignity while motivating the survivor to relearn basic skills the stroke may have taken away such as eating, dressing and walking. Although stroke is a disease of the brain, it can affect the entire body. Some of the disabilities that can result from a stroke include paralysis, cognitive deficits, speech problems, emotional difficulties, daily living problems, and pain. Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. A stroke patient may be unaware of his or her surroundings, or may be unaware of the mental deficits that resulted from the stroke. Stroke victims often have problems understanding or forming speech. Language problems usually result from damage to the left temporal and parietal lobes of the brain. A stroke can lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions in certain situations. One common disability that occurs with many stroke patients is depression -- more than a general sadness resulting from the stroke incident. Stroke patients may experience pain, uncomfortable numbness, or strange sensations after a stroke. These sensations may be due to many factors including damage to the sensory regions of the brain, stiff joints, or a disabled limb. According to the National Stroke Association, the total cost of stroke to the United States is about $43 billion a year, with direct costs for medical care and therapy estimated at about $28 billion a year. Sources: National Stroke Association, National Institute of Neurological Disorders and Stroke. Web Sites

4 American Stroke Association has a deep, authoritative site affiliated with the American Heart Association. Covers medical, rehabilitation, recovery, caregiving, prevention and research. National Center 7272 Greenville Avenue Dallas, TX Phone: STROKE National Stroke Association rich information site for resources, connections, local chapter network E. Easter Lane Englewood, CO Phone: STROKES Fax: National Stroke Association's Guide to Choosing a Stroke Rehabilitation Provider: Heart Disease and Stroke Statistics 2008 Update al.pdf Disaboom: Stroke The Brain Aneurysm Foundation offers medical detail on the condition, rehabilitation and recovery, physical and emotional topics. Local chapter network. Brain Aneurysm Foundation 12 Clarendon Street Boston, MA Phone: National Institute of Neurological Disorders and Stroke offers information on the medical aspects of stroke, risk factors, biomedical research, therapies, and rehabilitation. NIH Neurological Institute PO Box 5801

5 Bethesda, MD Phone: or TTY: The Stroke Network is a group of stroke support web sites designed to help "everyone in the stroke family." Support for survivors and caregivers. Features scheduled chats, message boards, survivor profiles, resource links, bookshop, more. Internet Stroke Center at Washington University at St. Louis has info for both patients and health care professionals as well as a clinical trials directory. Acurian, is the source for information on clinical trials and innovative new drugs and therapies. The Stroke Trials Directory site contains descriptions of completed and ongoing stroke therapeutic trials, positive and negative. World Stroke Organization provides access to stroke care and promotes research. SAFE (Stroke Awareness for Everyone) is an international Internet-centered coalition of stroke survivors and their families, in addition to doctors, nurses and therapists involved with stroke. Joint Commission on Accreditation of Healthcare Organization s Primary Stroke Centers To evaluate the quality of stroke care provided by hospitals, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), in collaboration with the American Stroke Association, developed Primary Stroke Center Certification. This program is based on the recommendations for primary stroke centers published by the Brain Attack Coalition and ASA's statements/guidelines for stroke care. The certification offers the "gold seal of approval" to hospitals that demonstrate compliance with consensus-based national standards along with performance measurement and improvement activities. Please also see their online children s book on stroke: When Grandpa Comes Home: A Story About Stroke

6 Pediatric Stroke Pediatric Stroke Network is a support group site for families and friends. The web site is directly associated with the American Heart Association. Defines childhood stroke and suggests first aid tips, rehabilitation techniques, and parent/family support. There is also a link for Toys for Special Needs. Children s Hemiplegia and Stroke Association (CHASA) a site for families of children who have hemiplegia, hemiparesis, and/or childhood stroke. Covers medical issues, rehabilitation, daily living, advocacy, insurance, connections to families and support groups. Some information in Spanish. CHASA Suite 305, PMB W. Green Oaks Arlington, TX Phone: Leave a message and a volunteer will call you back. HemiKids ( support group operated by CHASA) Kids Have Strokes Childhood Stroke & Hemiplegia Connections of Illinois American Stroke Association s info on Pediatric Stroke Constraint-Induced Movement Therapy Internet Stroke Center: Constraint-Induced Movement Therapy Constraint-Induced (CI) Movement Therapy (also known as Forced-Use Therapy). CI therapy involves intensive training of the weak (stroke affected) arm over about two weeks, while leaving the strong arm in a sling for much of each day. Positive results have been reported in animal models and in studies with small groups of patients.

7 American Stroke Association: Constraint-Induced Movement Therapy Excerpted from the article, "A Rehab Revolution," Stroke Connection Magazine, September/October Includes 2006 update. Pediatric Constraint-Induced Movement Therapy UAB Citivan International Research Center Phone: UAB-CIRC (select Sparks Clinics Option) Offers a protocol for pediatric constraint-induced therapy for children with a wide range of neuromuscular disorders. Magazines Stroke Connection Magazine American Stroke Association Published 6 times a year. Written for the consumer or patient. Free to individuals. Stroke Smart. National Stroke Association. Published 6 times a year Written for the consumer or patient. Free to qualified individuals. Topics in Stroke Rehabilitation. Thomas Land Publishers Quarterly. Written for the health care professional. The following books and videos are available for free loan from the PRC library. For more information, please see and click the Lending Library tab. Books Adams, Harold P., Gregory J. del Zoppo and Rudiger von Kummer. Management of Stroke: A Practical Guide for the Prevention, Evaluation, and Treatment of Acute Stroke. Caddo, OK: Professional Communications, 2002.

8 Adamson, Kate. Kate s Journey Triumph Over Adversity. Sevierville, TN: Insight Publishing Company, Autobiography of woman who experiences a double brain-stem stroke and has locked-in syndrome. Adamson, Kate. Paralyzed but not Powerless: Kate s Journey Revisited. Redondo Beach, Calif.: Nosmada Press, The Aphasia Handbook: A Guide for Stroke and Brain Injury Survivors and Their Families. New York: National Aphasia Association, Bauby, Jean-Dominique. The Diving Bell and the Butterfly. New York, NY: Vintage International, Autobiography of man with locked-in syndrome (a type of stroke). Berger, Paul E. and Stephanie Mensh. How to Conquer the World with One Hand and an Attitude. Merrifield, VA: Positive Power Publishing, nd ed. Autobiography Bergquist, William H. et al. Stroke Survivors. San Francisco: Jossey-Bass Publishers, The stories and challenges of survivors and caregivers. Biermann, June and Barbara Toohey. The Stroke Book: A Guide to Life After Stroke for Survivors and Those Who Care For Them. New York: Penguin, Bosworth, Kathleen. Your Mother has Suffered a Slight Stroke. Baltimore, MD: AmErica House, A daughter s story of dealing with her mother s stroke and searching for answers. Bradley, James Lee. Elvis Was My Speech Therapist. Victoria, B.C.: Trafford, Bradley s mother sang Elvis songs to him when he had his stroke at 18. Brady, Donna. When I Learn Surviving Stroke with Pride. Bloomington, IN: 1 st Books, Bruschi, Tedy. Never Give Up: My Stroke, My Recovery & My Return to the NFL. Hoboken, NJ: John Wiley & Sons, Burkman, Kip. The Stroke Recovery Book. Omaha, NE: Addicus Books

9 Butler, Dori Hillestad. My Grandpa Had a Stroke. Washington, D.C.: Magination Press, written for children Caplan, Louis R., Caplan s Stroke: A Clinical Approach. Philadelphia: Saunders Elsevier, th ed. Caplan, Louis R., Mark Dyken, and Donald Easton. Family Guide to Stroke. New York, NY: Times Books, Caplan, Louis R. Stroke. St. Paul, Minn.: AAN Press, American Academy of Neurology Quality of Life Guide for Patients and Families. Carr, Janet and Roberta Shepherd. Stroke Rehabilitation. London, ENG: Butterwoth Heinemann, Casper ML, Barnett E, Williams GI Jr, Halverson JA, Braham VE, Greenlund KJ. Atlas of Stroke Mortality: Racial, Ethnic, and Geographic Disparities in the United States. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, Casper ML, Denny CH, Coolidge JN, Williams GI Jr, Crowell A, Galloway JM, Cobb N. Atlas of Heart Disease and Stroke Among American Indians and Alaska Natives Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention and Indian Health Service, Chan, Hoy Ping Yee. Acupuncture for Stroke Rehabilitation: Three Decades of Information from China. Boulder, Colo.: Blue Poppy Press, Collins, Ellwyn K. with Mary Hughes. Unprepared!: A Husband s Story of Coping with His Wife s Stroke. Minneapolis, MN: Deaconess Press, Deits, Mary. My Exciting Stroke. Ridgecrest, CA: Frank and Mary Deits, depaola, Tomie. Now One Foot, Now the Other. New York: Puffin Books, Children s book about a grandfather having a stroke and the grandson helping him relearn to walk. De Paz, Madelina A. Stroke Brain-Assault: Suggestions, Encouragement and Exercises To Help You Or Your Loved One Overcome The Effects Of A Stroke. Nevada City, CA: Symposium Publishing, De Mille, Agnes. Reprieve: A Memoir. Boston: G.K. Hall & Co., 1982.

10 Choreographer de Mille had a massive stroke in Large type print. Derk, Tim. Hi Mom, Send Sheep! My Life As the Coyote and After. San Antonio, Texas: Trinity University Press, Former San Antonio Spurs mascot. Donnan, Geoffrey and Carol Burton. After a Stroke: A Support Book for Patients, Caregivers, Families and Friends. Berkeley, CA: North Atlantice Books, Douglas, Kirk. My Stroke of Luck. New York: William Morrow, Douglas, Kirk. My Stroke of Luck. HarperCollins, Unabridged audiobook. 2 audiocassettes. Read by Kirk Douglas and Michael Douglas. 3 hours. Edlow, Jonathan A. Stroke (Biographies of Disease). Westport, Conn.: Greenwood Press, Edmans, Judi, Annette Champion, Louise Hill, Mike Ridley, Fiona Skelly, Therese Jackson and Moya Neale. Occupational Therapy and Stroke. Philadelphia, PA: Whurr Publishers, Edsall, Susan. Into the Blue: A Father s Flight and a Daughter s Return. New York: St. Martin s Press, Edsall s father was a pilot who suffered a massive stroke. She and her sister devised their own rehab strategy to get their father fit enough to fly again. Fuzy, Jetta. Home Care for the Client Who Has a CVA. Albany, NY: Delmar, Garrison, Julia Fox. Don t Leave Me This Way. New York: Harper Collins, Garza, Donna Hall. Two Brainstem Strokes: Personal Choices and Struggles to Healing. Bloomington, IN: AuthorHouse, Gillen, Glen and Ann Burkhardt editors. Stroke Rehabilitation: A Function- Based Approach. St. Louis: Mosby, nd ed. Good, Gilbert. Short Circuit: Biography Of A Stoke As Told To My Husband. Victoria, BC: Trafford, 2005.

11 Greene, Valerie. Conquering Stroke: How I Fought My Way Back and How You Can Too. Hoboken, NJ: John Wiley & Sons, Greene, Valerie L. The Fire Within: A True Story of Triumph over Tragedy. Winter Park, FL: Alex Press, Guns, Bob. Rewire Your Brain Rewire Your Life: A Handbook for Stroke Survivors & Their Caregivers. Livermore, Calif.: Wingspan Press, Hachinski, Vladimir and Larissa Hachinski. Stroke: A Comprehensive Guide to Brain Attacks. Buffalo, NY: Firefly Books, Haggard, Herry W. I Had a Stroke and Survived. Salt Lake City, UT: Northwest Publishing, The true story of a physician who suffers a paralyzing stroke and his battle to rebuild his life. Handbook of Stroke. David O. Wiebers, editor. Philadelphia: Lippincott Williams & Wilkins, nd ed. Hankey, Graeme J. Stroke: Your Questions Answered. Second ed. Elsevier, Geared toward the health professional. Hinds, David M. After Stroke. London, England: Thorsons, Autobiography of a 100% recovery after two major strokes. Holmes, Carl Philip. I m Still Here: An Autobiography. Bloomington, Ind.: AuthorHouse, Holmes, Carl Philip. Married to the Vent: An Autobiography. Bloomington, Ind.: AuthorHouse, Hope: A Stroke Recovery Guide. Centennial, Colo.: National Stroke Association, Hope Through Research. Bethesda, MD: National Institute of Neurological Disorders and Stroke, National Institutes of Health, Houston, Polly. Stroke: Recovery With Oxygen. Flagstaff, AZ: Best Publishing Company, Howell, Patton and James Hall. Locked into Life. Boise, ID: Tea Road Press, 2002.

12 James Hall s life after a Locked-in Stroke. Hutton, Cleo. After a Stroke: 300 Tips for Making Life Easier. New York: Demos Medical Publishing, Hutton, Cleo and Louis R. Caplan. Striking Back at Stroke. Washington, DC: The Dana Press, Cleo s accounts of recovery after stoke. Johnson, Fred K. Right Hemisphere Stroke: A Victim Reflects on Rehabilitative Medicine. Detroit: Wayne State University Press, Josephs, Arthur. The Invaluable Guide to Life After Stroke. Long Beach, CA: Amadeus Press, Kaplan, Paul E., Rene Cailliet, and Candia P. Kaplan. Rehabilitation of Stroke. Burlington, MA: Butterworth Heinemann, Kleiman, Berenice. Lessons Learned: Stroke Recovery from a Caregiver s Perspective. Cleveland, Ohio: Cleveland Clinic Press, Kleiman, Berenice. One Stroke, Two Survivors: The Incredible Journey of Berenice and Herb Kleiman. Cleveland, OH: Cleveland Clinic Press, Klein, Bonnie Sherr. Out of the Blue. Berkeley, CA: Wildcat Canyon Press, Autobiography. Klein, Bonnie Sherr. Slow Dance: A Story of Stroke, Love, and Disability. Berkeley, CA: PageMill Press, Autobiography. Larkin, Marilynn. When Someone You Love has a Stroke. New York, NY: Dell Publishing, Guide to caregiving. Levin, Betty. Away to Me, Moss. New York; Greenwillow Books, Fiction for children about a girl working with a sheep dog that belongs to a stroke patient her mother is helping to rehabilitate. Levine, Peter G. Stronger After Stroke: Your Roadmap to Recovery. New York: Demos Medical Publishing, 2009.

13 Leys, Didier. Stroke Predisposing Conditions. London, UK: Remedica Publishing, Little, Michael Edward. Stranger in the Mirror: A True Story of Stroke Survival and Transformation Bloomington, Ind.: AuthorHouse, Lycke, Ruth E. Out of the Darkness & Into the Light: Answers for Stroke Using Traditional Chinese Medicine and Glyconutrients. Bloomington, Ind.: AuthorHouse, MacKay, Judith and George A. Mensah. The Atlas of Heart Disease and Stroke. Geneva: World Health Organization, Mantle, John. Cyclops Awakes. Lancaster, OH: Lucky Press, Autobiography. Marler, John R. Stroke For Dummies: Your Plain English Guide To Understanding, Preventing And Recovering From Stroke. Hoboken, NJ: Wiley Publishing, Inc., Maxwell, Roger et al. Taking Charge of Your Stroke Recovery: A Personal Recovery Workbook. Dallas, Texas: Taking Charge Books, Mayer, Tommye-K. Teaching Me to Run. Boston, MA: Prince-Gallison Press, Autobiography. McCann, Andy. Stroke Survivor: A Personal Guide to Recovery. London: Jessica Kingsley Publishers, McCann is a native of Wales and survived a stroke at the age of 37. McCarthy, Frank. Stroke. Bloomington, IN: 1 st Books, 2001 McCrum, Robert. My Year Off. New York, NY: Broadway Books, McEwen, Mark with Daniel Paisner. After the Stroke: My Journey Back to Life. New York: Gotham Books, (published in hardcover under Change in the Weather title) paperback McEwen, Mark with Daniel Paisner. Change in the Weather: Life After Stroke. New York: Gotham Books, 2008.

14 Medina, Pablo. The Cigar Roller: A Novel. New York: Grove Press, Fiction about a man paralyzed from a stroke. Meyer, Maria M. and Paula Derr. The Comfort of Home for Stroke: A Guide for Caregivers. Portland, Ore.: CareTrust Publications, Morgan, Mary. Like A Bolt: Tragedy to Triumph After Stroke: As I Lived It. Kitty Hawk, NC. LAF Publishing, Autobiography. Neal, Patricia. As I Am: An Autobiography. New York: Simon & Schuster, Newborn, Barbara. Return to Ithaca: A Woman s Triumph Over the Disabilities of a Severe Stroke. Shaftesbury, England: Element Books Ltd., Olson, Don A. Managing Stroke: A Guide to Living Well After Stroke. Washington, DC: NRH Press, Parker, James N. and Philip M. Parker. The Official Patient s Sourcebook on Stroke. San Diego, CA: ICON Health Publications, Parr, Susie, Judy Duchan and Carole Pound. Aphasia Inside Out: Reflections On Communication Disability. England: Open University Press, Parrish, Duane. A Postcard to Heaven. Green Forest, AR: New Leaf Press, Parrish was the pastor of a church in Oregon when a disabling stroke led him to thoughts of suicide. Pierce, Sherry L. I m O.K.: A Young Mother s Struggle. 1 st Books, Pruitt, Crayton J. A Crusade for Stroke Prevention. Tampa, FL: University of Tampa Press, Rao, Paul R., Mark N. Ozer and John E. Toerge. Managing Stroke: A Guide to Living Well After Stroke. Arlington, VA: ABI Professional Publications, Roberts, Wendy. Return: Stroke, Paralysis & Reflections on Recovery. Lubbock, Texas: Action Printing, biography

15 Robinson, Robin. Peeling the Onion: Reversing the Ravages of Stroke: A Father/Daughter Journey Through a Revolutionary Medical Treatment for Stroke. Key West, Fla.: Sora Publishing, Rudd, Anthony, Penny Irwin and Bridget Penhale. Stroke At Your Fingertips. London: Classic Publishing, Rymer, Robert A. and Marilyn M. Rymer. 911 Stroke!! True Stories of Stroke Reversal. Kansas City, Mo.: St. Luke s Hospital Foundation, Scheall, Norma. Life After Stroke. Bloomington, IN: AuthorHouse Senelick, Richard and Karla Dougherty. A Guide for Families Living with Stroke. Birmingham, AL: HealthSouth Press, Senelick, Richard C. and Karla Dougherty. La Vida Despues de un Accidente Cerebrovascular. Birmingham, AL: HealthSouth Press, 2003 Shapiro, Alison Bonds. Healing into Possibility: The Transformational Lessons of a Stroke. Novato, Calif.: New World Library, Biography. Shearer, Stephen Michael. Patricia Neal: An Unquiet Life. Lexington, KY: University Press of Kentucky, Biography of actress who suffered a stroke. Shirk, Evelyn. After the Stroke. Buffalo, NY: Prometheus Books, A woman s story of finding the answers and hope after her husband suffers a stroke. Sife, Wallace. After Stroke Enhancing Quality of Life. Binghamton, NY: The Haworth Press, Collected essays from medical advice, practical survivor techniques, information on resources, and personal store of triumph. Siles, Madonna. Brain, Heal Thyself: A Caregiver s New Approach to Recovery from Stroke, Aneurysm, and Traumatic Brain Injuries. Charlottesville, Va.: Hampton Roads Publishing, Simon, Sandy. A Stroke of Genius. Delray Beach, FL: The Cedars Group, Messages of Hope and Healing From a Thriving Stroke Survivor. Singleton, LaFayette with Kirk A. Johnson. Black Health Library Guide: Stroke. New York, NY: Kensington Publishing Corp., 1999.

16 Vital health information for African Americans Smith, Robert F. The Stroke of Midnight: A Brain Attack. Bloomington, Ind.: AuthorHouse, Biography Smith, Dr. Tom. Coping With Strokes. London, UK: Shelton Press, Smits, Johannes G. and Else C. Smits-Boone. Hand Recovery After Stroke. Boston, MA: Butterworth Heinemann, Sokol, Jennifer. 6 Years of Grace: Caregiving Episodes with My Mother. Tate Publishing, Sokol s mother suffered a stroke. Spence, J. David, M.D. How to Prevent Your Stroke. Nashville: Vanderbilt University Press, Stein, Joel, M.D. Stroke and the Family: A New Guide. Cambridge, MA: Harvard University Press, Stein, Joel, M.D., Julie Silver, M.D., Elizabeth Pegg Frates, M.D. Life After Stroke: The Guide to Recovering Your Health and Preventing Another Stroke. Baltimore: Johns Hopkins Press, Stone, Sharon Dale. A Change of Plans: Women s Stories of Hemorrhagic Stroke. Toronto: Sumach Press, Strauss, Lehman. In God s Waiting Room: Learning Through Suffering. Chicago: Moody Press, Strauss s wife Elsie suffered a severe stroke. He writes about key scripture passages on suffering. The Stroke Center Handbook: Organizing Care for Better Outcomes. UK: Informa Healthcare, Stroke Medicine. Martin M. Brown, Hugh Markus, Stephen Oppenheimer, editors. London: Taylor and Francis, Stroke Recovery & Rehabilitation. Joel Stein, et al. New York: Demos Medical, Reference book Stroke Sourcebook. Detroit, MI: Omnigraphics, nd ed.

17 Sulzer, James. Mom Comes Home: a memoir. James Sulzer, Sussler, Robert. A Brain s Battle Against a Stroke. Bloomington, Ind.: AuthorHouse, Taylor, Jill Bolte. My Stroke of Insight: A Brain Scientist s Personal Journey. Bloomington, Ind.: Jill Bolte Taylor, Timothy, Megan. Let Me Die Laughing! Waking From the Nightmare of a Brain Explosion. Idyllwild, Calif.: Crone House Publishing, Townsend, KD. Stealing Home: The truth about my mother s death. Prospect, Connecticut: Biographical Publishing, Triewth, Corrie L. (Genia Pauli Haddon was her pen name for other writings). Through A Stroke of Luck: Seeing Simple Mysteries of the Universe. Plus Publications, Shortly before her 60 th birthday, Triewth s vision was permanently impaired by facial shingles and weeks later she had a stroke that paralyzed her right side. Turner, Robert. Chasm Someone Took My Mind for a Walk. London, UK: Janus Publishing Company, Autobiography. Underwood, Helen. I Need Help : A Stroke Patient s Plea. Nevada City, CA: Blue Dolphin Publishing, US Department of Health and Human Services. A Public Health Action Plan to Prevent Heart Disease and Stroke. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and prevention; Wall, Bert. The Long Gray Tunnel: A True Story of Crisis, Spirit and Recovery. Austin, TX: Sunbelt Eakin, Wiebers, David. Stroke-Free for Life: The Complete Guide to Stroke Prevention and Treatment. New York, NY: Cliff Street Books, Wines, Renee. My Stroke A Will to Recover. New York: iuniverse, Autobiography. Wright, Russell. How to Survive a Stroke and Your HMO. Oxnard, CA: Pathfinder Publishing, Autobiography.

18 Videos Brain Attack: Importance of Immediate Treatment from Stroke. Sherborn, MA: Aquarius Healthcare Videos, (28 minutes) A Change of Character. Boston, MA. Fanlight Productions, (31:00) A man suffers a series of strokes which damaged his frontal lobes and changed his personality. Clot Busters: Case Studies of Stroke Treatment. Princeton, NJ: Films for the Humanities & Sciences, DVD (46 minutes) Communication: Aphasia. Healing Arts Communications, (24 minutes) Flawless. MGM, (111 minutes) Drama. Stars Robert DeNiro as a police officer partially paralyzed by a stroke. He takes singing lessons from a drag queen as speech therapy. VHS and DVD Harbor: Helping Patients & the Family Cope After a Loved One Had a Stroke. Sherborn, MA: Aquarius Healthcare Videos, (16 minutes) Jeremy and David s Story: Striking Back at Stroke. Princeton, NJ: Films for the Humanities & Sciences, (23 minutes) One Strong Arm. Boston, MA. Fanlight Productions, (19minutes) Preventing a Stroke. Information Television Network, DVD Satellite Symposium: Acute Stroke Treatment. American Stroke Association, Sit and be Fit. Spokane, WA: Sit and be Fit, Inc., (30 minutes) Specialty Exercise Video for Stroke. Strike Out Stroke: Knowing the Signs & Symptoms Could Help Prevent a Severe Attack. Sherborn, MA: Aquarius Health care Videos, (23 minutes) VHS (2000) and DVD (2005). Stroke Awareness. Stanford Health Video Library, minutes. DVD Stroke Help: Bed Positioning & Mobility for Families & Caregivers. Champion Productions, minutes.

19 Stroke Help: Improving Function & Awareness for Families & Caregivers. Champion Productions, minutes. Stroke Help: Preventing Shoulder Pain for Families & Caregivers. Champion Productions, minutes. Stroke Help: Standing Safely for Families & Caregivers. Champion Productions, minutes. Stroke Help: Self Care for Families & Caregivers. Champion Productions, minutes. Stroke Help: Treatment Strategies in Acute Care. Port Townsend, Wash.: International Clinical Educators, Set of 4 DVD with book. A training tool for healthcare workers. Stroke Help: Wheelchair Transfers for Families & Caregivers. Champion Productions, minutes. Stroke Prevention & Recovery: The Ultimate Video Guide. Stroke Education Limited, DVD set. Disk 1Understanding Stroke, Disk 2 Home Care & Rehabilitation, Disk 3 Coping with Stroke Aftermath. Stroke: The New Treatments. Princeton, NJ: Films for the Humanities and Sciences, VHS and DVD 19 minutes Stroke: Touching the Soul of Your Family. National Stroke Association. (15 minutes) Reducing stroke in African Americans. Surviving a Stroke. Calif.: Nostalgia Network, American Family series volume 35. DVD Treating Stroke. Princeton, NJ: Films for the Humanities & Sciences, (19 minutes) Understanding Stroke. Information Television Network, DVD Healthy Body Healthy Mind TV series. Very Annie Mary. Port Washington, NY: Koch Vision, DVD 100 minutes. The main character s father has a stroke and is a wheelchair user as a result. Comedy starring Rachel Griffiths.

20 Women, Stroke and the Red Dress: Cerebrovascular Disease in Women. Stanford, Calif.: Stanford Hospital and Clinics, (50 min.) DVD The information contained in this message is presented for the purpose of educating and informing you about paralysis and its effects. Nothing contained in this message should be construed nor is intended to be used for medical diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified health care provider. Should you have any health care related questions, please call or see your physician or other qualified health care provider promptly. Always consult with your physician or other qualified health care provider before embarking on a new treatment, diet or fitness program. You should never disregard medical advice or delay in seeking it because of something you have read in this message.