Isabelle’s Story (symptoms on right side of the body)

Isabelle had a stroke yesterday. She has right arm weakness and right leg weakness and the right side of her face is drooping slightly. Isabelle is having difficulty finding words (aphasia) but seems to understand when you talk to her. Isabelle is also having difficulty swallowing medication with water and coughs while eating (dysphagia). The doctors say she had a stroke in the left side of her brain.

Isabelle and her family asked the following questions:

What is a stroke?

A stroke is a sudden injury to the brain. A stroke is caused by uncontrolled bleeding in the brain, or by a blood clot in the brain that interrupts the blood flow to the brain. This limits oxygen to the affected part of the brain, causing injury or death to the cells in that area. The effect of the stroke depends on what part of the brain was injured and how much injury to the brain occurred.

video

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Click here to visit the Heart and Stroke Foundation website for more information on stroke including causes, types, symptoms and effects of stroke.

Why is arm weakness associated with stroke?

Damage to one side of the brain results in difficulties with movements on the other side of the body. Because of this, a person who has had a stroke on the left side of the brain may have difficulty moving the right side of the body. Many patients who have had a stroke experience muscle weakness (hemiparesis) or loss of movement (hemiplegia) on one side of their body.  This can affect their ability to use the arm on that side of the body. Muscle weakness or loss of movement can make it difficult to do everyday activities.

Some of the effective therapies to improve arm weakness in the early phase of recovery include:

Modified constraint-induced movement therapy (mCIMT)

Task-oriented training

Repetitive Transcranial Magnetic Stimulation (rTMS)

Functional electrical stimulation (FES)

Why is leg weakness associated with stroke?

Damage to one side of the brain results in difficulties with movements on the other side of the body. Because of this, a person who has had a stroke on the left side of the brain may have difficulty moving the right side of the body. Many patients who have had a stroke experience muscle weakness (hemiparesis) or loss of movement (hemiplegia) on one side of their body.  This can affect their ability to use the leg on that side of the body. Muscle weakness or loss of movement can make it difficult to do everyday activities.

Some of the effective therapies to improve arm weakness in the early phase of recovery include:

Functional electrical stimulation (FES)

Strength training

Why is facial paralysis associated with stroke?

Stroke can cause weakness in the muscles of the face. This is called facial paralysis and is caused by damage to a part of the brain that controls the muscles of the face. Facial paralysis can affect the ability to move one side of the face. This can in turn, impact on tasks such as eating, drinking and talking.

Why are communication difficulties associated with stroke?

Some patients find it difficult to communicate or use language after a stroke. This is referred to as aphasia. Aphasia is common in patients who have had a stroke on the left side of their brain. There are different types of aphasia and the symptoms depend on which area of the brain was affected. One type of aphasia affects the ability to say words and sentences. Patients may have difficulty finding the words they want to use. Another type of aphasia affects the ability to understand what people are saying. Aphasia can also affect the ability to read and write. Aphasia can range from mild to severe. It can be very frustrating for patients who cannot communicate their needs, feelings or thoughts to other people.

Click here for more information on Aphasia

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For more information on aphasia including symptoms, diagnosis, treatment and tips, visit the Aphasia Institute of Canada.

Why are swallowing difficulties associated with stroke?

Difficulty with swallowing after stroke is referred to as dysphagia. It is caused by damage to the areas of the brain that control the nerves or muscles used to swallow. If the area of the brain that controls muscle movements is affected, then it may be difficult to use the muscles of the lips, cheek, tongue, throat, or esophagus to move the food. This can cause aspiration or pneumonia.  If the area of the brain that controls sensation is affected, then it may be difficult to taste flavors, feel different textures, or identify the temperature of foods or drinks. Dysphagia may cause difficulty or discomfort when eating and drinking.

Click here for more information on Dysphagia

What about the family?

A stroke can be a very stressful event for the patient and his/her family members. Knowledge of stroke can help family members cope during this difficult time, and support the patient. Resources such as written information, group education programs and family support clinicians may be helpful for supporting patients and family members.