This question from a reader: Does stroke or spinal injuries create falling risk, double vision, executive difficulties just out of the blue?

1. Falling Risk

Stroke: Affects balance, coordination, muscle weakness, and sensation, making falls more likely.

Spinal Cord Injury: Can cause weakness, paralysis, or sensory loss, leading to instability and falls.

Falls are a major concern after a stroke or spinal injury due to muscle weakness, balance issues, and coordination difficulties. Here’s what you might do to keep from falling:

• Balance training: Work on stability with tai chi, yoga, or physical therapy exercises.
• Leg & core strengthening: Exercises like seated leg lifts, heel raises, and marching in place help.
• Use gym equipment carefully: Stick to seated machines or low-impact cardio (recumbent bike, elliptical) to reduce fall risk.
• Remove tripping hazards (rugs, clutter, wires).
• Install grab bars in the bathroom and near stairs.
• Use non-slip mats on the floor and in the shower.
• Ensure good lighting in hallways and staircases.
• Use a cane or walker if balance is an issue.
• Wear stable shoes (no flip-flops or heels).
• Stand up slowly from sitting/lying to avoid dizziness.
• Take your time with movements; rushing increases fall risk.
• Regular vision checks—eye issues can affect depth perception.

2. Double Vision (Diplopia) is another side effect. Here’s what you might do to improve Diplopia:

• Stroke can damage brain areas that control eye movement, causing double vision suddenly.
• Spinal Cord Injury is less common but possible if the injury affects nerves controlling the eyes.
• Sudden Onset could happen suddenly with a new stroke or gradually if nerve function deteriorates.
• Covering one eye (alternate eyes) can reduce double vision.
• Prism glasses, special lenses, prescribed by an eye doctor can correct alignment issues.
• Moving your eyes between near and far objects can improve control.
• Use stronger lighting to enhance visibility.
• Avoid staring at screens too long, as it strains the eyes.
• Use handrails when navigating stairs or uneven surfaces.

3. Executive Difficulties (Problems with Planning, Memory, Decision-Making) is yet another problem, but try these tips:

• Stroke can damage the frontal lobe or connections in the brain, leading to executive dysfunction.
• Spinal Cord Injury, if it affects brain communication, oxygen supply, or causes secondary conditions (e.g., chronic pain, depression), it may contribute to executive issues.
• A stroke could cause an immediate decline, but a slow worsening might suggest other neurological changes.
• A new stroke or mini-stroke (TIA) might occur fast.
• Increased spinal cord compression or nerve damage might happen.
• A new neurological condition (e.g., hydrocephalus, brain inflammation) could be evident.

Daily Organization Strategies

• Use a planner or phone reminders for tasks and appointments.
• Create routines to reduce decision fatigue (e.g., meal planning, set wake-up/sleep times).
• Break tasks into steps to make them more manageable.
• Keep important items in one place (e.g., keys, phone, wallet).

Brain Exercises

• Play strategy games (chess, Sudoku, crosswords).
• Try memory apps like Lumosity or Elevate.
• Read and discuss topics to engage thinking.

Lifestyle Support

• Get enough sleep. Fatigue worsens executive difficulties.
• Stay socially engaged. Talking to others helps cognitive function.
• Consider occupational therapy for specific cognitive rehab.

When to See a Doctor

• If falls, double vision, or executive difficulties worsen suddenly, see a doctor immediately.
• If double vision persists, an ophthalmologist or neurologist can help.
• If executive difficulties interfere with daily life, a neuropsychologist or speech therapist may assist with cognitive therapy.