1. The Effects of Stroke
Healing after an Ischemic Stroke.
By Dana Wyss

2. Hope(name changed to protect privacy)
Hope is a 57 year old African American female.
Hope works in an inpatient psychiatric hospital for
adolescents. Her line of work exposed her to a very high
level of stress.
She was feeling sick and asked for time off work by the
request of her MD.
While at home she lost touch with work and family on a
Tuesday 5/6/14.
On Sunday 5/11/14 police broke down her door to find her
on the floor unconscious. It was confirmed that she
suffered from an Ischemic Stroke at the hospital.

3. Ischemic Stroke
“An Ischemic Stroke
occurs when a clot or a
mass clogs a blood
vessel, cutting off the
blood flow to brain
cells. The underlying
condition for this type
of obstruction is the
development of fatty
deposits lining the
vessel walls. This
condition is called
atherosclerosis.”
http://watchlearnlive.heart.org/CVML_Player.php?moduleSelect=iscstr

4. Hope suffered a Left Brain
Stroke
Hope suffered the following symptoms which indicates the stoke occurred in
the left brain.
o Paralysis on the right side of the body
Right arm, hand, fingers
Facial droop
Partial paralysis of right leg
Able to move right foot
Speech/language problems (Broca’s Area affected)
Unable to speak the first week.
After week two able to understand speech but struggled to get
words out.
Behavioral style
Her behavior and personality were intact
Memory loss
Some memory loss related to names, certain words, people who
had visited, what happened the day before her stroke up until in
the hospital.

5. Immediate Treatment
Medical Care in
Hospital
Restore blood
flow to the
affected area of
the brain as
quickly as
possible
Alteplase
(thrombolytic
therapy)
The medicines
used for the
early treatment
of ischemic
stroke are
alteplase,
aspirin, and
anticoagulants.
Consultation
with a
neurologist
(physician who
specializes in
the brain) and
has intensive
care services
and imaging (eg,
CT scan or MRI)
http://www.uptodate.com/contents/ischemic-stroke-treatment-beyond-the-basics

6. Rates of Recovery
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
http://www.stroke.org/site/PageServer?pagename=REHABT

7. Within a week Hope was
transferred to rehabilitation.
This was a good sign and pointed to possible full
recovery or recovery with only minor
impairments.
Treatment in the Rehabilitation Center included:
Occupational Therapy
Speech Therapy
Physical Therapy
Dietary education
Medical treatment

8. Visits with Hope
Hope and I visited several times throughout this
experience.
She had a positive attitude and it was a pleasure to
see that her personality and humor was present each
visit.
Each week there was significant progress in her
speech and movement.
This class helped me to have in-depth conversation
with her regarding her stroke, treatment and future
plans that others either avoided or could not
understand.

9. Consultation
As an art therapist I was determined to use this
class and my knowledge of art to assist hope in
her journey to recover. I consulted with a physical
therapist to create activities for us to do together
to further support her healing.
Hope struggled with “tip of the tongue” as she
called it
Later at night when tired she struggled to think of
how or what to say
When focusing too hard to say or remember
something she would say and write nonsensical
things

10. Helping the Speech flow
We did art (painting, drawing, coloring) to help
her with her dexterity, expression, creativity and
to have time together without speech.
We used card games, dominoes and watched TV
shows while talking to help the speech flow.
The more she focused just on speech the more
she struggled to find the words
The more she struggles the more frustrated she
would become
By using distraction it helped her speech to come
more naturally

11. Why Art Heals
Art expression bypasses Broca’s area of the
brain and gives access to traumatic and general
memories that facility healing.
Van Der Kolk, 1994

12. Friends and Family
One important aspect of Hope’s recovery was
the support she received from friends and
family. She had a great deal of love, visits and
kind words.

13. Current Progress
MD and hospital were surprised by the rate of her progress and
determination to heal. She has surpassed expectations
considering the length of time between the stroke and first
treatment.
Speech is greatly improved
Still has difficulty at night
With certain words or phrases
When tired
Movement in right arm up and down
Able turn arm back and forth
Some movement in fingers
Recovered all movement to right leg
Able to walk unassisted

14. References
• Ischemic Stroke retrieved on July 10, 2014 from
http://watchlearnlive.heart.org/CVML_Player.php?mo
duleSelect=iscstr
• Rates of recovery retrieved on July 10, 2014 from
http://www.stroke.org/site/PageServer?pagename=R
EHABT
• Treatment of stroke retrieved on July 10, 2014 from
http://www.uptodate.com/contents/ischemic-stroke-
treatment-beyond-the-basics
• van der Kolk, BA. (1994) The body keeps the score:
memory and the evolving psychobiology of
posttraumatic stress. Harvard Review of Psychiatry.
1994 Jan-Feb;1(5):253-65.