What is a stroke?
A stroke is when a clogged or burst artery interrupts blood flow to the brain. This interruption of blood flow deprives the brain of needed oxygen and causes the affected brain cells to die. When brain cells die, function of the body parts they control is impaired or lost.
A stroke can cause paralysis or muscle weakness, loss of feeling, speech and language problems, memory and reasoning problems, swallowing difficulties, problems of vision and visual perception, coma, and even death.
What physical and emotional problems occur after a stroke?
Common warning signs of a stroke include the following:
- sudden numbness or weakness of the face, arm and/or leg
- sudden confusion, trouble speaking, or difficulty understanding speech
- sudden difficulty seeing in one or both eyes
- sudden trouble walking, dizziness, loss of balance, or loss of coordination
- sudden severe headache with no known cause
If you or anyone you know experiences any of the above warning signs, call your doctor or go to an emergency room immediately.
Because of the organization of our nervous system, an injury to one side of the brain affects the opposite side of the body. Often the person loses movement and/or feeling in the arm and/or leg opposite the side of the brain affected by the stroke. So, if a person has a stroke on the left side of the brain, he or she may have weakness or paralysis in the right arm and leg. This makes it difficult for the person to perform activities of daily living (e.g., dressing, feeding, bathing, tying shoes, etc.). It is also common for survivors of stroke to tire easily.
After a stroke, a person may be able to see objects in only certain parts of his or her field of vision. Visual perception of everyday objects may also change. Objects may look closer or farther away than they really are, causing the person to spill at the table or bump into things while walking. Some people may lose awareness of their weaker side and ignore or forget about it. As a result, they may have trouble reading because they only see half of the page. They may only dress one side of their body thinking they are fully dressed. This one-sided neglect is most common when there is damage to the right hemisphere of the brain.
Stroke survivors often show inappropriate emotions and extreme mood fluctuations. They may laugh when something isn't funny or cry for no apparent reason. This is particularly common early on in the recovery process.
Persons who have had a stroke may seem very self-absorbed. They may demonstrate an intense need for a structured, unchanging routine. They may be very frustrated with their inability to communicate effectively, and this may lead to anger and depression.
What communication problems occur after a stroke?
After a stroke, some people experience language deficits (aphasia) that significantly impair their ability to communicate. These deficits vary depending on the extent and location of the damage. Read a detailed discussion of aphasia.
Deficits in social communication skills (pragmatics) may result in the following:
- Difficulty sequencing thoughts together to tell a story
- Switching topics without warning, or seeming to "go off on tangents" without informing the listener
- Difficulty taking turns in conversation
- Problems maintaining a topic of conversation
- Trouble using an appropriate tone of voice
- Difficulties interpreting the subtleties of conversation (e.g., sarcasm, humor)
- Problems "keeping up" with others in a fast-paced interaction
- Reacting inappropriately; seeming overemotional (overreacting), impulsive, or "flat" (without emotional affect)
- Having little to no self-awareness of inappropriate actions or responses
Oral motor functioning is sometimes affected by a stroke. The following problems may occur:
- Muscles of the lips and tongue may be weaker (dysarthria) or less coordinated (apraxia).
- Speech may not be clear.
- Breathing muscles may be weaker, affecting the patient's ability to speak loudly enough to be heard in conversation.
Muscles may be so weak that the person is unable to speak; consequently, he or she may need augmentative or alternative communication aids to help express ideas (e.g., a communication board).
Weak muscles may also limit the ability to chew and swallow effectively (dysphagia). Read a detailed discussion of swallowing problems.
What cognitive problems occur after a stroke?
Cognition refers to thinking skills. Cognitive difficulties are common in people who have had a stroke on the right side of the brain, and they vary in seriousness depending on the location and severity of the damage. The following problems may occur:
- Not being aware of one's surroundings
- Poor attention to tasks
- Memory difficulties
- Poor reasoning skills
- Poor problem solving skills
- Poor executive functioning (e.g., goal setting, planning, initiating, self-awareness, self-inhibiting, self-monitoring and evaluation, flexibility of thinking)
- Trouble concentrating when there are internal and external distractions (e.g., carrying on a conversation in a noisy restaurant, dividing attention among multiple tasks/demands)
- Slower processing of new information
- Recent memory is affected in some people, making new learning difficult. For example, some people may have trouble learning the new things they are being taught, such as how to get in and out of their wheelchair safely.
How is a stroke diagnosed?
A stroke is diagnosed by medical professionals. Special tests that allow doctors to look at the person's brain (CT scan, MRI) are often used to determine where the stroke occurred and how severe it is.
A speech-language pathologist (SLP) works with other rehabilitation and medical professionals and families to provide a comprehensive evaluation and treatment plan for stroke survivors. The team may include:
- doctors
- nurses
- neuropsychologists
- occupational therapists
- physical therapists
- social workers
- employers/teachers (when applicable)
To contact a speech-language pathologist, visit ASHA's Find a Professional.
What other organizations have information about a stroke?
This list is not exhaustive and inclusion does not imply endorsement of the organization or the content of the Web site by ASHA.
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