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Physical effects on either side of the brain

  • Stroke usually affects one side of the brain. Movement and sensation for one side of the body is controlled by the opposite side of the brain.

    • This means that if your stroke affected the left side of your brain, you will have problems with the right side of your body.
    • If your stroke affected the right side of your brain, you will have problems with the left side of your body.

    Changes that may happen after a stroke on either side of the brain include the following.

    Abnormal muscle tone

    This is a nerve problem that can make your movements slow and jerky. There are stages of muscle tone recovery:

    • Your limb or joint may be limp and floppy.
    • Your limb or joint may move on its own when your muscle tone starts to return. It doesn't always do what the brain tells it do to.
    • Your limb or joint begins to respond to your brain.

    Bladder changes

    You may have problems urinating or controlling your urine (urinary incontinence).

    These problems can be caused by damage to the parts of your brain that control your bladder. You might also have an infection.

    Your doctor or nurse can help you regain your normal control.

    Bowel changes

    Constipation is the most common problem after a stroke. This may be caused by lack of liquids or limited physical activity.

    Your doctor or nurse can help you regain your regular bowel pattern.

    Cognitive problems

    You may have problems with memory, thinking, attention or learning. For example, you may:

    • have trouble following directions
    • get confused if something in a room is moved
    • be unable to keep track of the time and date
    • have trouble making decisions
    • have short-term memory loss.

    Because of these concerns, you may do things that are not safe.

    Coordination problems

    You may have reduced hand-eye coordination. When reaching for an object, your arm may waver or your hand may overshoot the object.

    Dysarthria

    Signs of aspiration

    Watch for these signs of aspiration:

    • a wet-sounding voice
    • breathing you can hear
    • struggling when breathing or swallowing
    • shortness of breath
    • rattling sound in your lungs
    • higher body temperature.

    Dysarthria (dis-AR-three-a) means you have a speech problem caused by damage to the motor center in your brain. You know the right words, but have problems saying them.

    Weakness or lack of coordination in your lips, tongue and mouth muscles may affect your:

    • voice
    • word pronunciation
    • speech rate, rhythm and/or resonance
    • ability to chew, suck or swallow
    • breathing.

    If you have mild dysarthria, you may have clear or slightly slurred speech.

    If you have severe dysarthria, you may be unable to move or coordinate your speech well enough to be understood. A speech-language pathologist will likely work with you.

    Dysphagia

    Dysphagia (dis-FAY-ja) means you have a swallowing problem caused by weakness or loss of feeling in your tongue, lips, palate and/or throat.

    You may have problems:

    • moving food around your mouth
    • with food sticking in your throat
    • coughing or choking on liquids or solids.

    Choking prevention

    You can reduce your risk of choking by doing the following:

    • Check with your speech-language pathologist or doctor if you cough when you swallow.
    • Don't try to stop a cough. A cough is your body's natural protection against choking.
    • Stop eating if you can't stop coughing or if you can't clear your airway. Call 911 right away.
    • Drink thickened liquids to slow down coughing or choking. Gelatin, pudding powder or potato flakes can thicken liquids. The texture of food and the utensils you use will affect you ability to swallow.

    A doctor or speech-language pathologist will recommend the correct diet for you.

    He or she may recommend some ways to help your swallowing. These include:

    • correct body and head positions
      • Stay as upright as you can.
      • If you are in bed, make sure the head of the bed is as high as it can go.
      • Bend your knees so you won't slide.
      • Put pillows behind your back.
      • Keep your head slightly bent downward. This will keep food and liquid from going into your lungs (aspiration).
    • correct food texture
    • correct food quantity
    • correct feeding utensils and containers.

    If you can't eat or drink by mouth, you will need to get your nutrients by a tube. This will keep food a liquids from getting in your lungs.

    • A nasogastric feeding tube is passed through your ose and esophagus to your stomach. This will be used for short-term tube feedings.
    • A gastrostomy tube is put through your abdominal wall into your stomach. This will be used for long-term feedings when your recovery is slow.

    The dietitian will suggest which feeding product will fit your schedule. Tube feedings will be closely watched for any problems or adjustments.

    Your ability to swallow may return during recovery. The speech-language pathologist will give you updates on your progress.

    Emotional changes

    Please see the section on emotional effects.

    Endurance problem

    You may find you are unable to do a task or activity for a long period of time. This should get better as you get stronger.

    Fatigue

    You can expect to be tired as your body learns or relearns how to work.

    Hemiparesis or hemiplegia

    Hemiparesis (hem-ee-par-Ee-sis) or hemiplegia (hem-ee-PLEE-ja) means you may have weakness, partial or complete paralysis on one side of your body or must one arm or one leg.

    • If the stroke was on the left side of your brain, the right side of your body will be affected.
    • If the stroke was on the right side of your brain, the left side of your body will be affected.

    Impulsivity

    You may act without planning ahead.

    Judgment

    You may not know your own limits. You may act without thinking about the consequences of your actions. You may misinterpret situation. You may be unable to judge, problem-solve, organize and/or use "abstract" reasoning skills.

    Memory problems

    You may have poor memory. This may lead to problems retaining, blending and recalling information.

    Sensation changes

    You may have numbness or loss of feeling in different parts of your body.

    Sexuality concerns

    It is rare that a medical concern would keep you from sexual activity. Fear may keep you from being intimate with your partner. You may feel anxiety about:

    • how you look
    • changes in your relationship
    • rejection.

    Talk to your partner about how you feel. Talk about how the two of you can become close and tender again. Talk with your doctor if you are having intimacy concerns.

    Vision changes

    You may ignore or not be able to see anything toward your right. You may only eat from the left side of your plate or read from the left side of a page.

  • Source: Allina Health Patient Education, Understanding Stroke: Information about Stroke and Recovery, fourth edition, ISBN 1-931876-13-4
    Reviewed by: Allina Health Patient Education experts
    First reviewed: 02/01/2006
    Last reviewed: 12/09/2011


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