Oct 2, 2026 · 37 min · 15 segments
Send us Fan Mail The **2026 Guideline for Adult Stroke Rehabilitation and Recovery** from the American Heart Association and American Stroke…
Lorie G. RichardsGuestAngie CauthornHostAnd so and this is one thing I didn't know until after being post-stroke was the way the brain is, the part that gets damaged in the storm, as it were, in the stroke, that part doesn't come back.

One, because it's been disconnected from some neurons it used to be connected to and it doesn't like that.

And also, though, because there's all kinds of inflammation that happens after a stroke and our neurons don't like inflammation, so they don't function as well.

Some of that recovers and those neurons come back online and start working again as you recover from stroke.

And so how much of that recovers and comes back will really partially determine how much you can reduce your impairment.

So in the hand, there's an area of the brain called cortical spinal tract.

Now it starts up here in your cortex, which is the outer part of the cells, and it then travels all the way down to your spinal cord.

Now, I know that's an old analogy because we don't have telephone wires much anymore, but it's like the electric lines that come into your house and the power plant is the brain, okay? So if you cut, if you have too much damage to that cortical spinal tract where it travels down to the spinal cord, you can't, the neurons can be firing and telling your arm to do stuff, but your arm never gets the message.

And unfortunately, there's a really tiny area in the brain that it goes through that gets hit a lot by stroke.

So if you totally damage that cortical spinal tract, we don't know how to get your hand working very well.

Now, there's a few fibers that come from the other side of your brain that can help a little bit, but not enough to give you really good hand functions.
And so and this is one thing I didn't know until after being post-stroke was the way the brain is, the part that gets damaged in the storm, as it were, in the stroke, that part doesn't come back.

One, because it's been disconnected from some neurons it used to be connected to and it doesn't like that.

And also, though, because there's all kinds of inflammation that happens after a stroke and our neurons don't like inflammation, so they don't function as well.

Some of that recovers and those neurons come back online and start working again as you recover from stroke.

And so how much of that recovers and comes back will really partially determine how much you can reduce your impairment.

So in the hand, there's an area of the brain called cortical spinal tract.

Now it starts up here in your cortex, which is the outer part of the cells, and it then travels all the way down to your spinal cord.

Now, I know that's an old analogy because we don't have telephone wires much anymore, but it's like the electric lines that come into your house and the power plant is the brain, okay? So if you cut, if you have too much damage to that cortical spinal tract where it travels down to the spinal cord, you can't, the neurons can be firing and telling your arm to do stuff, but your arm never gets the message.

And unfortunately, there's a really tiny area in the brain that it goes through that gets hit a lot by stroke.

So if you totally damage that cortical spinal tract, we don't know how to get your hand working very well.

Now, there's a few fibers that come from the other side of your brain that can help a little bit, but not enough to give you really good hand functions.
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