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Diseases & Conditions

Stroke&the Brain

(Also Called 'Stroke and the Brain - Risk Factors')

A stroke can result in behavioral changes. These changes can vary and are based on the stroke’s severity and the part of the brain in which the stroke takes place.

The largest portion of the brain—the cerebral cortex—has two hemispheres. The right hemisphere of the brain controls nonverbal communication, emotions and spatial orientation or sense of body position. The left hemisphere of the brain controls the right side of the body and is the brain’s language center. The left hemisphere also is largely responsible for analytical thinking.

Right-brain injury

Damage to this side of the brain can cause a range of problems in a person’s emotions and behavior. A stroke survivor with right-brain injury may be unaware of his or her impairment and be certain that he or she can perform the same tasks as before the stroke. This individual also may experience emotional lability, poor judgment, short attention span and short-term memory loss.

Often, the spatial-perceptual difficulties involved in right-brain injuries are overlooked. When individuals with right-brain injuries have problems performing simple activities, these individuals may be seen as uncooperative, confused, overly dependent or unmotivated.

Caregivers can take steps to help stroke survivors deal with limitations of right-brain injury once those limitations are realized. If you are a stroke survivor with a right-brain injury, it is important that you are aware of potential dangers in your environment. The following are some tips:

For stroke survivors with right-brain injury, it is important to:

  • Keep a safe environment. All items that have the potential to be dangerous (e.g., poisons, cleaning chemicals and sharp objects) should be kept in a safe place.
  • Remember to scan (turn your head from side to side) in order to see what would usually be ignored on the affected side.
  • Acknowledge the affected part of your body as still a part of you. Remember the affected side of your body by touching it or rubbing it.
  • Don’t try to handle all activities alone. Ask for help if you are in a situation where you may become injured or confused.
  • Encourage caregivers to be sensitive to your visual and sensory difficulties. For instance, make sure that caregivers place items that you may need on your right side if you cannot perceive things on your left side.
  • Minimize environmental clutter and distractions. Too much visual or auditory stimulation in your environment may be dangerous and may add to your confusion. Calm and quiet surroundings can help you focus on a given task.
  • Help prevent injuries that may result from your inability to determine depth and distance. Make sure that pointed edges on things such as furniture and doorways are clearly marked.

Stroke survivors with right-brain injuries frequently have speech and communication problems. Many of these individuals have a hard time pronouncing speech sounds properly because of the weakness or lack of control in the muscles of the mouth and face. In addition, survivors may have difficulty interacting normally because of problems with their “thinking” skills.

A speech/language therapist can assist the survivor and family members in dealing with communication problems.

Left-brain injury

Left-brain stroke survivors may experience personality changes, communication problems and some paralysis on the right side. Survivors with left-brain damage—unlike those with right-brain damage—tend to behave in a cautious, compulsive, or disorganized way and are easily frustrated. People with left-brain injury may be slow to take action or to respond to questions.

The behavior and mood changes linked to left-brain injury can be frustrating to the survivor as well as to the caregiver. In assisting the survivor in his or her attempts to perform as normally as possible, it is important for the caregiver to:

  • Develop strategies permitting the survivor to function at a comfortable pace. The organization of daily routines and schedules needs to be done with care.
  • Recognize and address fatigue. Fatigue can be a roadblock to recovery. Encourage the survivor to ask for help or to delegate duties.
  • Be patient. Do not try to rush the survivor into a response to your questions or comments. Resist the temptation to answer for him or her.
  • Unless you are aware that the survivor has a hearing problem, speak in a normal voice.
  • Give immediate and frequent feedback to the survivor in the form of words or by non-verbal gestures.
  • State questions so that the survivor can give a “yes” or “no” answer. Keep comments simple.

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 1/20/2012...#10408