Effects of Stroke on the Right Side of the Brain: An In-Depth Look at What to Expect

Experiencing a stroke can significantly change the lives of survivors and their loved ones. Although each stroke is different, being aware of potential impairments is crucial to recovery. This blog post provides a comprehensive list of possible effects of stroke on the right side of the brain. It provides more information about what you or your loved one may experience during the recovery period.

When the blood flow to the brain's right hemisphere is interrupted or reduced, it leads to a stroke on the right side. This results in brain cells being deprived of oxygen and nutrients. The right hemisphere of the brain is responsible for controlling the left side of the body. It also plays a crucial role in regulating emotions, spatial awareness, and other complex functions.

So, What are the Effects on the Brain of a Right-Sided Stroke?

Motor Skills and Coordination

Affected Brain Regions: Parietal and Motor Cortex

These regions control spatial orientation and voluntary movements.

• Left-Sided Weakness or Paralysis: It affects everything from walking to holding objects. The level of impairment varies, from no active motion to minor strength losses.

• Difficulty Swallowing (Dysphagia): Difficulties swallowing food due to weak oral muscles can lead to aspiration pneumonia and nutritional deficits.

• Coordination Issues: Tasks that require precise hand-eye coordination, such as writing, tying shoelaces, or catching a ball, may become difficult. The person may drop objects frequently.

• Muscle Stiffness (Spasticity): Your muscles may feel tight or rigid, moving difficult and causing discomfort or pain.

Advanced Cognitive and Executive Function Deficits

Comprehending the advanced cognitive and executive function impairments resulting from a stroke on the right side is crucial. These impairments could obstruct decision-making, problem-solving, and other essential cognitive functions for self-independence.

Decision-Making and Planning

Affected Brain Regions: Prefrontal Cortex, Orbitofrontal Cortex

These brain areas are crucial for planning, organizing, and making decisions based on evaluating outcomes and options.

• Impaired Decision-Making: It can be challenging to make decisions, especially when evaluating options and foreseeing consequences. This can lead to poor choices.

• Reduced Planning Abilities: Tasks that involve multiple steps, such as cooking a meal or scheduling a day, can be overwhelming and cause stress.

• Inconsistency and Unpredictability: Individuals may exhibit varying decision-making abilities, leading to inconsistent behavior and increasing caregiver stress.
  

Problem-Solving and Logical Reasoning

Affected Brain Regions: Prefrontal Cortex, Inferior Frontal Gyrus

These areas are responsible for logical reasoning, problem-solving, and abstract thinking.

• Reduced Problem-Solving Skills: Daily tasks like organizing your schedule and planning meals can become significant challenges.

• Concrete Thinking: Individuals may struggle to understand abstract ideas and strategies, favoring concrete thinking.

• Impaired Judgement: People can make irrational or dangerous decisions, not because they are ignorant of the risks but because they cannot accurately measure them.
  

Working Memory and Task Switching

Affected Brain Regions: Dorsolateral Prefrontal Cortex

This area involves holding and manipulating information for short periods and switching between tasks.

• Reduced Working Memory: This affects multitasking, making it difficult to follow directions or cook.

• Difficulty in Task Switching: Individuals may need help to shift their attention between different tasks, affecting multitasking abilities and reducing productivity.
  

Spatial Neglect

Affected Brain Regions: Parietal and Frontal Lobes

These lobes manage attention control and environmental awareness.

• Unilateral Spatial Neglect: Survivors with spatial neglect usually have trouble focusing on stimuli on their left side, known as left hemispatial neglect. While right hemispatial neglect (due to damage in the left hemisphere) is less common, it is still possible. People with this condition may disregard objects or individuals on their left side, only eat food from the right side of their plate, or forget about their left arm as it hangs off their wheelchair or bumps against a wall.

• Unilateral Spatial Inattention: This is a milder form of neglect where patients can identify objects and people on the left side with cues and have fewer deficits in daily function.
  

Reduced Alertness

Affected Brain Regions: Reticular Activating System (RAS), Frontal Lobe

The RAS and frontal lobe are responsible for maintaining baseline alertness and consciousness.

• Lethargy and Sluggishness: Reduced alertness can manifest as persistent fatigue and a lack of enthusiasm for activities, even those previously enjoyed.

• Slow Response Time: This could affect everything from conversation to reaction to physical stimuli, like catching a falling object.

• Impaired Awareness of Deficits: Reduced alertness can also make it difficult for individuals to recognize or understand their other impairments.
  

Sustained Attention Deficits

Affected Brain Regions: Prefrontal Cortex, Parietal Cortex

These areas are essential for maintaining focus on tasks for extended periods.

• Difficulty Completing Tasks: The individual may start various activities but need help to finish the task.

• Easily Distracted: External stimuli easily distract, making concentrating in noisy or busy environments difficult.

• Inconsistent Performance: There might be fluctuations in attentional capabilities, making it hard to predict how well a person will perform on a given task from one moment to the next.

Emotional and Behavioral

Understanding the emotional and behavioral deficits that can occur after a right-sided stroke is essential for comprehensive care and effective rehabilitation. These deficits are often less visible but can be as debilitating as physical impairments.

Emotional Regulation

Affected Brain Regions: Limbic System, Frontal Cortex, and Amygdala

These brain structures are crucial in mood regulation, emotional response, and social behavior.

• Flat Affect: Lack of emotional expression can be misinterpreted as disinterest or lack of engagement, affecting both facial expressions and vocal tone, leading to difficulties in social situations.

• Emotional Lability: The sudden and often uncontrollable emotional outbursts can be stressful for both the person experiencing them and those around them. These could range from sudden laughter to tears without an apparent trigger.

• Emotional Apathy: A decreased emotional responsiveness can cause withdrawal from social activities and hobbies, affecting relationships and quality of life. This may be misinterpreted as depression, but it is actually a neurological issue.

Impulse Control and Social Behavior

Affected Brain Regions: Frontal Cortex and Pre-frontal Cortex

These areas are responsible for inhibitory control, social judgment, and ethical decision-making.

• Reduced Inhibitory Control: Stroke survivors may find it difficult to control impulses, manifesting as abrupt or inappropriate comments or gestures.

• Social Awkwardness: Impaired social cognition can result in misunderstandings, inappropriate behavior, or difficulty reading social cues. This can strain relationships and lead to isolation.

• Ethical and Moral Reasoning: Changes in the ability to discern right from wrong can happen, leading to choices that are out of character for the individual.
  

Anxiety and Depression

Affected Brain Regions: Limbic System, particularly the hippocampus and frontal lobes

These areas are closely related to emotional well-being, and their impairment can lead to mood disorders.

• Increased Anxiety: Stroke survivors may develop new fears or phobias or experience a heightened state of general anxiety.

• Depression: While emotional apathy is not depression, the conditions can coexist. Depression after a stroke is common, affecting 1 in 3 stroke survivors, and requires professional intervention.

Vision Deficits

Affected Brain Regions: Occipital Lobe and Parietal Lobe

These lobes handle visual interpretation and spatial understanding.

• Loss of Depth Perception: This is inconvenient and hazardous, as it can lead to tripping over objects and misjudging distances while driving.

• Visual Neglect: This severe lack of awareness of one side of the visual field can result in overlooking obstacles, affecting mobility and safety.

Somatosensory Deficits

Affected Brain Regions: Parietal Lobe, particularly the postcentral gyrus

This section of the brain is essential for processing sensations, including touch, pain, temperature, and body positioning (proprioception).

• Reduced Sensation of Touch: People may experience a decreased sense of touch on their left side, making it harder to grasp objects.

• Impaired Pain Perception: Pain is a warning sign our bodies send us. Suppose we have reduced or altered pain perception. In that case, it can be dangerous because we might not recognize an injury or condition that needs medical attention.

• Temperature Insensitivity: The ability to sense temperature changes may be reduced, leading to difficulty distinguishing between hot and cold and increasing the risk of accidental burns or frostbite.

• Loss of Proprioception: This refers to awareness of one's body position in space. A deficit in proprioception can affect balance and spatial orientation, making walking or picking up objects difficult.

Final Thoughts on Effects of stroke on the right side of the brain.

Caregivers and stroke survivors must understand how a right-sided stroke affects stroke survivors. This knowledge can lead to modified approaches to daily living tasks and therapeutic interventions to address their deficits.