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Understanding Secondary Strokes

Published May 23, 2019

With the death of celebrity Luke Perry earlier this year, the devastating effects of stroke have been even more widely discussed. It’s vital—and life-saving—to know the signs of a stroke and what to do if you suspect you or a loved one is experiencing one.

But what if you’ve already had a stroke? It’s important to be vigilant about secondary stroke—which can be even more debilitating, according to the National Stroke Association.

“A stroke that occurs after an initial transient ischemic attack (mini-stroke) or stroke is called a secondary stroke,” explains Barrie Arth, PT, DPT, the Supervisor of Outpatient Physical Therapy at Burke’s main campus in White Plains. “It is important to know the difference, as secondary strokes can be more severe and disabling than the initial (primary) event.” In fact, according to the National Stroke Association, secondary strokes account for about 25 percent of strokes.

Here are some key things to know:

Understand the risk factors. Along with having experienced a stroke before, there are other risk factors that could up your chances of another, including hypertension, atrial fibrillation, high cholesterol, diabetes and circulatory problems. Plus, along with non-modifiable risk factors like family history, race and age, she says, “There are lifestyle risk factors such as poor diet and nutrition, obesity, physical inactivity, tobacco use and alcohol consumption.”

Incorporate lifestyle changes. Switching up your behaviors is important: “Take control of your risk factors that are modifiable to promote a healthier lifestyle. Make healthier nutrition choices, add physical activity to your daily routine, and quit smoking and drinking,” says Arth. And this can have a big impact. Take exercise, for instance. “All patients are provided a home exercise program and education for caregivers so that they can continue their exercises prescribed by their therapist at home.” Gyms like Burke’s Adult Fitness Center not only offer group exercise classes and the ability to work with personal trainers, but specific programs such as Fit for Life After Stroke.

And coming soon? “Stroke patients who have completed their inpatient rehabilitation can be eligible for additional nutrition education and cardiac rehabilitation classes taught by a qualified instructor.”

Medication might be recommended. Arth explains that some of the prevention techniques for a secondary stroke may involve medications, such as antihypertensive medication. “This is not appropriate for all patients, so checking with your doctor and following through with their recommendations is very important in prevention of a secondary stroke.”

Follow-up—and check in with your therapists. “When a patient is discharged from the inpatient stroke program, they are booked a follow-up appointment with one of our physicians so we can continue to oversee the care and progress of patients once they have entered the community,” says Arth. Be sure to stick with this appointment—and also feel free to check in with your therapists post-discharge.

“We love to hear from patients!” says Arth. “We encourage patients to come in for a new physical, occupational and speech therapy evaluation if they notice any change in their functional or cognitive status so that we can update their home program, provide patients and caregivers new training and assist patients to gain more independence.”  

Take advantage of resources—especially as a caregiver. In addition to providing educational opportunities during a patient’s inpatient stay, such as learning to make healthier lifestyle choices, there are other resources available, such as Burke’s Stroke Support Group, which is free and meets monthly. And for caregivers, specifically, Arth says, “Take care of yourself! In addition to promoting a healthy lifestyle for the patient, take control of your health too, participate in the rehabilitation process and take advantage of all the support that Burke can offer through the Marsal Caregiver Center and support groups.”

As always, remember F.A.S.T: “It is important for caregivers to know the warning signs of a stroke and act F.A.S.T. F—Face: Ask the person to smile. Does one side of the face droop? A—Arms: Ask the person to raise both arms. Does one arm drift downward? S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange? T—Time: If you see any of these signs, call 9-1-1 right away,” says Arth. The National Stroke Association also has detailed information on F.A.S.T.

Burke Rehabilitation Hospital's Comprehensive Stroke Rehabilitation Program creates a continuum of care that lasts a lifetime. More than 800 patients come to Burke for post-stroke rehabilitation with 93 percent of discharged patients returning to their communities. Patients are able to continue to see their Burke/Montefiore physician after discharge for follow up care. They can also receive treatment from Burke’s highly trained therapists at any one of our nine outpatient locations.

Learn more about Burke’s stroke rehabilitation program.

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