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Effects of stroke (cerebrovascular accident or CVA): Physical effects on either side of the brain
Stroke (cerebrovascular accident or CVA) 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 (retention) or controlling your urine (urinary incontinence in men or women). 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
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.
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:
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 stroke survivors 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.
Visual field loss
You may ignore or not be able to see anything toward your right. You may only eat from the left side of your plate ore read from the left side of a page.
Some problems that happen after stroke are more common with stroke on one side of the brain that the other. In most people, the left side of the brain control the ability to speak and understand language. The right side of the brain controls the ability to pay attention, recognize things you see, hear or touch, and be aware of your own body.
In some left-handed people, language is controlled by the right side of the brain and awareness by the left side of the brain.
Related Links
Effects of left-sided stroke: Aphasia and language apraxia
Physical medicine and rehabilitation specialists
Source: Allina Patient Education, Understanding Stroke: Information about Stroke and Recovery, third edition, ISBN 1-931876-13-4
First published: 02/01/2006
Last updated: 02/01/2006
Reviewed by: Allina Patient Education experts