Intellect, sensation, perception and movement, all honed over the course of a lifetime, are the very abilities most compromised by stroke. Stroke can rob people of the most basic methods of interacting with the world.
The specific abilities that will be lost or affected by stroke depend on the extent of the brain damage and, most importantly, on the location of the stroke in the brain. The brain is an incredibly complex organ, and each area within the brain has responsibility for a particular function or ability. The brain is divided into four primary parts: the right hemisphere (or half), the left hemisphere, the cerebellum and the brain stem.
The right hemisphere of the brain controls the movement of the left side of the body. It also controls analytical and perceptual tasks, such as a judging distance, size, speed, or position, and seeing how parts are connected to wholes.
A stroke in the right hemisphere often causes paralysis in the left side of the body, known as left hemiplegia. Survivors of right-hemisphere strokes may also have problems with their spatial and perceptual abilities. This may cause them to misjudge distances (leading to a fall) or be unable to guide their hands to pick up an object, button a shirt or tie their shoes. They may even be unable to tell right-side from up-side down when trying to read.
Along with their impaired ability to judge spatial relationships, survivors of right-hemisphere strokes often have judgment difficulties that show up in their behavioral styles. These patients often develop an impulsive style, unaware of their impairments and certain of their ability to perform the same tasks as before the stroke. This behavioral style can be extremely dangerous. It may lead the stroke survivor with left-side paralysis to try to walk without aid. Or it may lead the survivor with spatial and perceptual impairments to try driving a car.
Survivors of right-hemisphere strokes may also experience left sided neglect. Stemming from visual field impairments, left-sided neglect causes the survivor of a right-hemisphere stroke to "forget" or ignore objects or people on their left side.
Some survivors of right-hemisphere strokes will experience problems with short-term memory. Although they may be able recount a visit to the seashore that took place 30 years ago, they may be unable to remember what they ate for breakfast that morning.
The left hemisphere of the brain controls the movement of the right side of the body. It also controls speech and language abilities for most people. A Left-hemisphere stroke often causes paralysis of the right side of the body. This is known as right hemiplegia.
Someone who has had a left-hemisphere stroke may also develop aphasia. Aphasia is a term used to describe a wide range of speech and language problems. These problems can be specific, affecting only one part of the patient's ability to communicate, such as the ability to move their speech-related muscles to talk properly. Patient may be completely unimpaired when it comes to writing, reading or understanding speech.
In contrast to survivors of right-hemisphere stroke, patients who have had a left-hemisphere stroke often develop a slow and cautious behavioral style. They may need frequent instruction and feedback to complete tasks.
Finally patients with left-hemisphere stroke may develop memory problems similar to those of right-hemisphere stroke survivors. These problems can include shortened retention spans, difficulty in learning new information and problems in conceptualizing and generalizing.
The cerebellum controls many of our reflexes and much of our balance and coordination. A stroke that takes place in the cerebellum can cause abnormal reflexes of the head and torso, coordination and balance problems, dizziness, nausea and vomiting.
Strokes that occur in the brain are especially devastating. The brain stem is the area of the brain that controls all of our involuntary, "life support" functions, such as breathing rate, blood pressure and heartbeat. The brain stem also controls abilities such as eye movements, hearing, speech and swallowing. Since impulses generated in the brain's hemispheres must travel through the brain stem on their way to the arms and legs, patients with a brain stem stroke may also develop paralysis in one or both sides of the body.
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