Do questions become more difficult to ask after a stroke?

A fellow caregiver asked...

According to doctors I had two strokes, two months apart in 2005. I was told to keep my stress level low even though they said it was attributed to my smoking. I can now walk straight, although I still get dizzy spells and sometimes people can't understand what I am asking. Do questions become more difficult to ask after a stroke and how can I prevent another one?

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

To answer your first question, yes they can. Typically, language can be effected in two ways. The first of those is if the muscles of the mouth are not working properly, and your speech becomes slurry. The second is if the language center in the brain is effected, and you lose your English abilities, such that your words don't make grammatical sense, or you have trouble searching for the right words to say. In either case, I would not give up hope. Although the typical rule of thumb is that stroke symptoms plateau six months after a stroke, I have certainly seen a few patients who are able to improve long after that. Continuing to work on your language skills - by activities such as reading and writing - can be quite helpful.

To answer your second question, it depends. There are usually 3 main causes for a stroke (I am assuming here that yours was an "ischemic" stroke - the most common type caused by a blockage of blood flow). Those are 1) arterial disease, 2) heart disease, 3) clotting disorder. You should have a thorough screen for each of those, and a plan to deal with the problem. Typically, the treatment includes thinning of the blood and treating other modifiable risk factors such as getting your blood pressure and cholesterol under good control. If you have any questions about whether this is being adequately addressed, you should see a Stroke Specialist or a Neurologist in your area.