A Wild Ride
by Polly Logan,
PAC Executive Assistant and Publications Administrative Coordinator
While on a family vacation this past August, I got a call that I was definitely not expecting: Your sister has had a stroke. This was especially shocking since my sister, who is 39 years old, didn’t have any of the major risk factors for a stroke. It started with a couple days of moderate headache, but then the pain suddenly became extremely severe. She lost most of the function of her limbs, speech, eyesight, and hearing. Needless to say, this was a frightening experience for her two young children, who were home alone with her at the time.
After a battery of tests in the emergency room, it was determined that she had experienced a severe infarction (stroke) in her cerebellum, a region in the brain near the base of the skull. During her nearly month-long hospitalization, her symptoms were quite severe. Because the cerebellum of the brain controls posture and balance, she experienced such constant intense vertigo that she was unable to open her eyes for an entire week. She said it felt as if she were violently spinning and falling at the same time on a really wild ride. Without a properly functioning cerebellum to help orient you in space, walking is impossible, and she wasn’t even able to sit upright. The cerebellum also controls coordination of movements, so even her small hand movements and swallowing were significantly affected. The cerebellum is involved in speech production, so her speech was slow and slurred. Recently, studies have suggested that the cerebellum also plays a role in higher brain function, such as decision-making, paying attention, planning ahead, and emotional regulation. In my sister’s case, these thinking skills were definitely diminished after the stroke, and she actually doesn’t remember much of her time in the hospital.
I am happy to report that, due to my sister’s young age and the intense rehabilitation care that she was fortunate to receive, she has made approximately an 85% recovery at present. However, she is now, as we say, living with brain change. During this experience with my sister, I became very aware of the correlation between what she was experiencing and some of the common symptoms of dementia. As the cerebellum becomes affected by the death of brain cells seen in dementia, balance issues, lack of coordination of movement, difficulties with speech and swallowing are all commonly seen. The role in of the cerebellum in higher brain function of thinking, emotional control, and attention, while not yet completely understood, are also typically affected. Unfortunately, for those living with dementia, their symptoms are progressing rather than improving. However, when one understands why those living with dementia are experiencing these symptoms, it helps one to be more aware, patient, and sensitive. We also know that stimulating this area of the brain through various therapies, as I saw so vividly with my sister, increases blood flow to that region and helps optimize what remains. For instance, physical and occupational therapy can be very valuable at helping maintain balance and reducing fall risks during the progression of dementia. By being aware of the reasons for symptoms and helping them keep what remains as long as possible, we can help to support those living with all forms of brain change.