Post-Stair Fall: Weakness in Left Hand After Stroke - What to Do?

Just fell down the stairs and have weakness in my hand?

The patient has a history of a left-sided stroke and right leg amputation.
A few days ago, while climbing stairs, they accidentally fell from the second floor to the first floor, resulting in slight swelling on the outside of the brain.
They immediately went to the hospital for examination, and the assessment indicated that there were no major issues with the brain.
However, that same night at home, the left hand, which is affected by the previous stroke, showed significant weakness, and the fingers could not be fully extended.
Should the patient return for a follow-up appointment immediately? Could this be related to the brain injury or the overall physical condition? The patient is now very concerned about potential brain issues and is worried that the strength in the left hand may not recover.
If a follow-up is necessary, which specialty should they consult? Thank you.

Zhi Ming, 50~59 year old female. Ask Date: 2016/03/29

Dr. Zhang Junwei reply Neurosurgery

Problems with the cervical nerves can also cause weakness in the hands; please consult a neurosurgeon.

Reply Date: 2016/03/29

More Info

After experiencing a fall from the second floor, especially given your history of a stroke affecting the left side of your body, it is crucial to take your symptoms seriously. The immediate concern is the weakness in your left hand, which has become more pronounced since the fall. While the initial examination indicated that there was no significant damage to your brain, the development of weakness in your left hand could suggest a few possibilities that warrant further investigation.

Firstly, the weakness in your left hand could be a result of several factors. Given your history of stroke, it is possible that the fall may have exacerbated any existing neurological deficits. Strokes can lead to a variety of complications, including muscle weakness, coordination issues, and changes in sensation. The fact that you are unable to fully extend your fingers may indicate that the motor pathways that control these movements are affected. This could be due to the stroke itself or could be a new issue arising from the fall.

Additionally, even if the brain scan did not show any major issues, there could still be subtle changes or swelling that are not immediately apparent. The brain is a complex organ, and even minor trauma can lead to changes in function. Symptoms such as weakness, numbness, or changes in motor control should always be taken seriously, especially in someone with a history of neurological issues.

Given these considerations, it is advisable to seek medical attention promptly. You should return to your healthcare provider, ideally a neurologist, who can assess your current condition. They may recommend further imaging studies, such as an MRI, to evaluate for any changes in the brain that could be contributing to your symptoms. Additionally, a physical therapist or occupational therapist may be involved in your care to help you regain strength and function in your left hand.

In terms of rehabilitation, it is essential to start as soon as possible. Early intervention can significantly improve outcomes after a stroke or any neurological injury. Your therapy may include exercises to improve strength, coordination, and range of motion in your left hand. Therapists often use techniques such as constraint-induced movement therapy, which encourages the use of the affected limb, or other modalities to stimulate recovery.

As for your concerns about the potential for long-term weakness, it is difficult to predict outcomes without a thorough evaluation. Recovery from a stroke can vary widely among individuals, and factors such as the extent of the initial injury, the timing of rehabilitation, and your overall health will play a role in your recovery. However, many individuals do see improvements over time with consistent therapy and support.

In summary, given your recent fall and the new onset of weakness in your left hand, it is crucial to seek medical advice as soon as possible. A neurologist will be able to assess your condition and determine the best course of action. Early rehabilitation is key to maximizing recovery, so do not hesitate to pursue therapy options. Your proactive approach to your health will be vital in navigating this challenging situation.

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