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Patient Education

Right Brain Stroke



The right side (hemisphere) of the brain controls the left side of the body. It also helps with thinking (cognition).

The right side of the brain helps to:

  • Make decisions
  • Make judgments
  • Make plans
  • Show emotions
  • Visually be aware of and understand the world around us (visual perception)
  • Solve problems
  • Remember

A stroke on the right side of the brain can cause changes in:

  • Communication
  • Movement
  • Vision and touch
  • Thinking
  • Perception
  • Behavior
  • Denial of disability

Communication:

Speaking and understanding is not usually affected. A person may have trouble with:

  • Starting a conversation or taking turns in a conversation
  • Rambling speech
  • Problems with writing or spelling
  • Staying on topic

Movement:

A person may have trouble with:

  • Paralysis or weakness on the left side of the body
  • Poor balance
  • Loss of ability to plan how to move (apraxia)
  • Poor coordination
  • Eye-hand coordination
  • Too much muscle tone (spasticity) or too little (flaccidity)
  • Tiredness, lowered endurance (fatigue)
  • Moving too quickly (impulsiveness)

Vision and Touch (Sensation):

A person may have trouble with:

  • Increased sensitivity to touch
  • Decreased or loss of feeling on left side of body
  • Loss of part of vision on the left side; can see things on the right side better
  • Ignoring items on the left side (left-sided neglect)
  • Tunnel vision
  • Double and/or blurred vision
  • Uncontrolled movements of the eye (nystagmus)
  • Trouble judging how far away something is (depth perception)

Thinking:

A person may have:

  • A short attention span or is easily distracted
  • Problems finishing long tasks (concentration)
  • Problems recalling and storing recent information (memory problems)
  • Trouble learning new information
  • Poor judgment (impulsiveness)
  • A lack of awareness of abilities (impulsiveness)
  • Trouble with time – 5 minutes seem like an hour (time disorientation)
  • Confusion about day, month, year, time of day, place or person (disorientation)
  • Repeats the same thing over and over (perseveration)
  • Trouble adjusting to changes in daily routines
  • Problems with sense of direction; gets lost easily
  • Trouble knowing important information from unimportant information
  • Problems doing tasks in proper order (sequencing)

The person is unable to:

  • Plan events or tasks, draw conclusions and make decisions (problem solving)
  • Use money or make change
  • Do simple math problems
  • Dial a telephone without making errors

Perception

(awareness of the body, environment and other people):

The person:

  • Has problems with grooming habits (dressing, brushing teeth, bathing, etc.)
  • Ignores the left side of the body (left-sided neglect)
  • Feels as if the left arm or leg belongs to someone else
  • Is unable to recognize time on a clock
  • Is unable to understand tone of voice or facial expressions
  • Has problems judging distance, size and position
  • Moves without thinking (impulsiveness)
  • Has problems separating a part from the whole object, for example, brakes on a wheelchair

Behavior:

The person:

  • Cries or laughs at the wrong times (emotional lability)
  • Shows lack of interest (apathy)
  • Does not want to do a task (lack of motivation)
  • Has trouble starting a task (initiation)
  • Is irritable
  • Is confused
  • Is depressed
  • Focuses on self (self-centered)
  • Shows lack of sensitivity to others feelings
  • Has trouble controlling impulses and emotions, causing temper flare-ups
  • Is impulsive
  • Tries to do things without help (SAFETY PROBLEM)
  • Shows little awareness of problems from stroke
  • Makes sudden, quick movements
  • Shows restlessness, agitation – may increase at night

Denial of Disability:

  • Is unaware of physical and thinking problems
  • Tries to do things without help, which may be dangerous to self (SAFETY ISSUES)

What are common behaviors with a right brain stroke?

A person with a right brain stroke may show:

  • Impulsive behavior
  • Rambling speech or actions
  • Trouble paying attention
  • Poor memory
  • Short attention span
  • Disregard for left side
  • Lack of awareness of effects of stroke (overestimates ability)

These behaviors make the person a SAFETY RISK. A safety risk means that a person is not safe to be left without close supervision to protect him or her from harm.

Helpful Suggestions:

  • Approach from left side. Makes the person more aware of left side to help with left-sided neglect.
  • Slow the person down if moving too fast. Moving too fast could cause harm or injury (impulsive).
  • Sit next to the person. Place hand on the arm to silence or limit behavior. Helps stop or limit inappropriate behavior.
  • Keep a day-to-day routine. Repetition will help memory.
  • Give reminders and simple directions to finish task.
  • Needs reminders to finish task (short attention span).
  • Point out effects of a stroke. Reminds the person of problems and increases awareness (overestimates ability).