Will he recover from this stroke?

A fellow caregiver asked...

My relative had a stroke on Aug. 12. He still cannot stand alone, get out of bed, and has paralysis on his left side. Some brain damage. He just isn't showing progress. Can you answer this question? Do you think he will get better? Oh, he cannot sit up in bed, has to be propped up.

Expert Answer

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

Unfortunately, I don't have a great answer for you. Recovery after a stroke is notoriously hard to predict. The only rule that is almost always true is that the patient should not get worse over time. Beyond that, some people make no recovery, some people make a moderate recovery, and some people make a complete recovery. The vast majority of recovery is over the first 6 months after the stroke. Often, you can plot the recovery course over time and this will give you a fairly good sense of the speed of recovery. For example, plot out a graph of his strength on the affected side over time - or keep a diary - and this should help you predict how his progress will continue.

At about 2 months, the rate of recovery slows. At about 6 months, the recovery usually stops.

The best thing you can do for him is be extremely encouraging, and to continue to make him exercise his affected side. The harder he works at rehabilitation, the better he will get.

Your question is a good one, and is frequently asked of stroke doctors. Unfortunately, like some other scientific fields (like predicting the economy, or predicting long term weather forecasts) despite all of our technology, we are very bad at making accurate predictions. I wish we were better.