Stroke post-traumatic stress risk

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Many stroke sufferers are left with post-traumatic stress disorder (PTSD), a British study suggests.

More than a third of 105 brain haemorrhage survivors tested positive for the disorder, with flashbacks and painful memories of their bleed.

This is a similar level to that found in soldiers returning from war zones and amongst victims of sexual assault, Neurosurgery journal reports.

The authors of the study say diagnosing and treating PTSD will aid recovery.

Subarachnoid haemorrhage affects about 8,000 people in the UK each year and is a sudden leak of blood over the surface of the brain. Doctors do realise this type of stroke is stressful for the patient, but they do not always ask the patient about anxiety and depression. Someone needs to Professor Allan House of the Stroke Association

Although emotional distress following this type of stroke is common, it is under-recognised, they say, partly because clinicians tend to focus on physical recovery.

The team from Durham University, the James Cook University Hospital in Middlesbrough and the Newcastle General Hospital assessed the patients at three months and again at 13 months after their subarachnoid haemorrhage using a simple questionnaire.

At both stages, the answers given suggested 37% of the patients had PTSD.

Traumatic event

The authors say their findings are not surprising, given the nature of this type of stroke - its sudden, often unexpected and painful onset in relatively young people, requiring emergency invasive investigations and surgery.

Add to this having to deal with the fact that they have had a life-threatening illness, it is understandable why many patients experience emotional reactions, they say.

Adam Noble and his team say it is relatively easy to spot which stroke patients are at greatest risk of PTSD by looking for signs of "poor" coping, such as denial and self-blame.

These patients could be offered pre-emptive treatment, they say.

Mr Noble suggested tailored treatment such as group therapy "and, where possible, prevention through teaching patients more appropriate stress-coping strategies after they suffer a stroke".

Professor Allan House of the Stroke Association said: "Doctors do realise this type of stroke is stressful for the patient, but they do not always ask the patient about anxiety and depression. Someone needs to.

"Some patients undoubtedly have PTSD, while others might have depression or anxiety after a subarachnoid haemorrhage and it is understandable why."

Peter Chapman, from Hartlepool, suffered a subarachnoid brain haemorrhage at the age of 45 in 2001.

His PTSD was not picked up until two years after his stroke.

He said: "The first six months were the worst. I was so worried that it might happen again and I have never shed so many tears in my life.

"If I had been tested and treated for PTSD right from the beginning, my life would have been 500% better than what it has been, and would have made the world of difference to my recovery."