Which side of the brain is worse to have a stroke
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May 20, 2021 Last Updated: June 30, 2022 Video TranscriptHi, I’m Dr. List, and I am a physical medicine and rehabilitation doctor. I am the medical director for the Stroke Program here at Brooks. I’m also the medical lead for the Spasticity Management Program. Though we see general patterns in stroke based on the area of the brain that is affected, every stroke and how it affects someone can vary. I get asked a lot about the size of the stroke and how it impacts a patient’s prognosis, rehabilitation and recovery. Though the size of the stroke certainly can influence recovery, a small stroke in a critical area of the brain can also cause a lot of damage. So it is important for us to take an individualized approach to each and every patient in their stroke rehabilitation. Generally speaking, a stroke on one side of the brain will cause weakness on the opposite side of the body. With strokes to the right side of the brain, we can develop weakness on the left side of the body. We may also develop changes in how we think, act and process information. In general, when the left side of the brain is affected, we can develop weakness on the right side of the body. And often, our language ability may also be affected. And we could develop what is called aphasia, which is when we either lose the ability to speak, we lose the ability to understand speech or both. What is great about the Brooks Stroke Rehabilitation Program is that we work together as a team to develop a rehabilitation program specific to the patient, wherever they are in their stroke recovery. I came to Brooks probably a year and a half to two years ago, and I was very happily overwhelmed with just the various resources that Brooks offers to their patients, both from the inpatient perspective all the way to the outpatient, and long-term recovery. As a stroke rehabilitation physician, there’s a lot that I can offer my patients in terms of helping them along through their recovery. So maybe it’s when you first come to Brooks Rehabilitation on the inpatient side and you’re working with a very specialized team of neuro rehabilitation from your physicians to the nurses to the therapist who are sub-specialized in neuro rehabilitation, and really know how to help you along your journey to recover from the inside out. Some of the resources are things like the Brain Injury Day Treatment Program, getting you back to driving through our Brooks Rehabilitation Drivers Program, talking about getting back to work or seeing work in a new way, by working with our vocational rehab specialists in the Brooks Brain Injury Clubhouse, perhaps your speech was significantly affected after the stroke and we get you involved in the Aphasia Center, or you want to get involved in our Adaptive Sports Program, which is so great. Or you just want to maintain your general fitness and we get you involved in our Brooks YMCA Stroke Wellness Program. Really the options and the resources that Brooks has for your recovery are endless. Medical ReviewerCassandra List, MDMedical Director of the Stroke Program, Medical Leader for the Spasticity Management Program and the Brain Injury Day Treatment ProgramCassandra List, MD is board certified in physical medicine and rehabilitation. She completed her medical degree at the University of Illinois College of Medicine in Chicago and her residency at Medical College of Wisconsin. After her residency, Dr. List completed one of the only Neurorehabilitation and Spasticity Management Fellowships in the country, which consisted of an extra year of extensive, specialized training focusing on neurorehabilitation and the use of botulinum toxin injection and intrathecal baclofen pumps to optimize function. At Brooks Rehabilitation, Dr. List works both in the inpatient rehabilitation hospital as well at an outpatient clinic with a focus on neurorehabilitation and spasticity management. After a right hemisphere stroke, it’s important to understand the unique side effects that may occur. Every stroke is different, and therefore a stroke on the right side of the brain causes different side effects in different individuals. There are many patterns among right hemisphere stroke survivors that are worth understanding. Although everyone will experience them differently, it can be helpful to educate yourself about these potential effects so that you can work with your therapist to effectively address them. Use the links below to jump straight to any section:
Understanding Right Hemisphere StrokeA stroke occurs when the supply of blood in the brain is obstructed and prevents an area from receiving enough oxygen-rich blood. There are two main types of stroke: ischemic stroke where a blood clot obstructs an artery in the brain, and hemorrhagic stroke where a blood vessel in the brain bursts. While a stroke is happening, the oxygen-deprived brain cells begin to die, which is why a stroke is considered to be a medical emergency. Immediate medicate treatment can restore the normal flow of blood or stop the bleeding that is causing brain tissue death. The best way to identify a stroke is to recognize the early warning signs: facial drooping, loss of sensation or weakness on half of the body, and slurred speech. Sometimes a piercing headache is involved, too. Upon arriving to the hospital for treatment, doctors will restore blood flow either through clot-busting drugs (for ischemic stroke) or surgery (for hemorrhagic stroke). After treatment, the road to recovery begins. Patients must work to overcome the side effects created by the impact of the stroke. Secondary Effects of Right Hemisphere StrokeWhat could be affected after a stroke occurs on the right side of the brain? Each half of the brain controls the opposite side of the body. Therefore, a stroke on the right side of the brain results in impairments on the left side of the body. Furthermore, actions controlled by the right hemisphere may become impaired, too. Right hemisphere strokes may result in the following stroke side effects: Hemiplegia or Hemiparesis: Weakness or Paralysis on One Side of the BodyHemiplegia refers to paralysis on the affected side of the body, whereas hemiparesis is defined as weakness on the affected side of the body. After a stroke on the right side of the brain, functional impairments manifest on the left side of the body. Right-sided stroke survivors may struggle with moving their left leg, arm, or hand. The size of the stroke may be correlated to the severity of the impairments. For instance, a massive stroke in the right hemisphere might lead to paralysis on the left side of the body (hemiplegia) instead of hemiparesis (weakness). Prosopagnosia: Difficulty Recognizing Faces After a right hemisphere stroke, some patients may have difficulty recognizing faces – a condition known as prosopagnosia. Many suspect that the inability to recognize faces is linked to damage to the fusiform gyrus (according to an article from CNN), which resides in the right hemisphere of the brain. Damage in this region may cause right-sided survivors difficulty in recognizing family members’ faces, which can be distressing to loved ones. Left neglect: Unaware of Environment on Left SideImage from Journal of Neurology When stroke occurs in the right parietal lobe, some patients may lose the ability to pay attention to the left side of their environment. For example, they may not eat the food on the left side of their plate because they are not aware that it’s there. This is a condition called hemineglect in which stroke survivors have problems observing and attending to the objects in the environment on their left side. To illustrate this problem, see the image above from the Journal of Neurology where a patient with a right hemisphere stroke was instructed to fill in the numbers on a clock. You will notice that all the numbers have been crammed into the right side because the patient suffers from left neglect. Homonymous Hemianopia: Visual Changes to Each Eye
The visual cortex spans across both hemispheres of the brain, so vision problems can occur after a stroke that affects either side of the brain. In patients with homonymous hemianopia, one half of the opposite field of vision will be affected. When a stroke on the right side of the brain damages the visual cortex, it can blind patients on the left side of each eye. Anosognosia: Neglect or Denial of DisabilityUnfortunately, some right-sided stroke survivors are in denial of their physical disabilities because the stroke has impacted their self-awareness. A condition called anosognosia occurs when a person with a disability is unaware of its existence. Anosognosia often results from damage to the parietal lobe or fronto-temporal-parietal area in the right hemisphere of the brain. Unfortunately, this condition may prevent right hemisphere stroke survivors from seeking treatment because they are in denial that disability exists to begin with. Pseudobulbar Affect: Sudden Outbursts of EmotionSome stroke survivors may find themselves having uncontrollable outbursts of emotion, like laughter or crying, that are often unrelated to the situation. This condition is called pseudobulbar affect or emotional lability. Patients with pseudobulbar affect may laugh at something that isn’t nearly as funny, for example, or they may laugh inappropriately at a story that is sad. This condition is neurological and occurs in about half of stroke patients. It should not be confused with other psychiatric disorders like post-stroke depression. Now that you understand the side effects of a stroke on the right side of the brain, what can you do for rehabilitation? Rehabilitation Methods for Right Hemisphere Stroke SurvivorsRehabilitation and treatment of a right side stroke involves restoring as much function as possible. The side effects listed above can be remedied, at least partially, by participation in the following rehabilitation methods and stroke recovery treatments:
It’s important for survivors to work closely with a team of therapists to address any effects of a right hemisphere stroke. Not only can your therapist help directly treat any issues, but they can also provide guidance as you develop your own regimen to follow at home. Right Hemisphere Stroke RecoveryIt’s important to note that rehabilitation takes time and the duration varies among patients. Fortunately, your brain is on your side! When you put in the work during rehabilitation, the brain works hard to rewire itself through neuroplasticity. The brain just needs your help by putting in the time and the reps. You can also support yourself by talking to your therapist to generate a treatment plan for your unique right hemisphere stroke recovery. Which side of the brain is more likely to have a stroke?Introduction. Several hospital-based studies have reported that left-sided strokes are more frequent than right-sided strokes. A predilection for the left side may be explained by characteristics of the atherosclerotic plaque in the left carotid artery or by anatomy.
What does a stroke on right side of brain affect?The effects of a right hemisphere stroke may include: Left-sided weakness or paralysis and sensory impairment. Denial of paralysis or impairment and reduced insight into the problems created by the stroke (this is called "left neglect") Visual problems, including an inability to see the left visual field of each eye.
What happens if you have a stroke on the left side of your brain?Left Brain
If the stroke occurs in the left side of the brain, the right side of the body will be affected, producing some or all of the following: Paralysis on the right side of the body. Speech/language problems. Slow, cautious behavioral style.
Do strokes happen on the right side?Definition. A right brain stroke happens when blood supply to the right side of the brain is stopped. The right side of the brain is in charge of the left side of the body. It also does some thought processing, help us know body position, and judge space and distance.
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