As a result of a stroke, functional changes can occur depending on the area of brain injured. These changes can significantly affect the patient’s independence and lifestyle. Many of these changes can be treated so as to achieve complete or partial recovery depending on the intensity of the injury:
- Motion: paralysis or weakness of muscles in one side of the body, muscle limpness or stiffness, and coordination or balance difficulties. A person who has suffered a stroke in the left part of his/her brain will suffer from weakness or paralysis in the right side of his/her body. In comparison, a person who has had a stroke on the right will suffer from weakness or paralysis in the left side of the body. These changes can affect switching position when lying down, sitting stably, walking, switching the body’s position and swallowing (as a result of muscle weakness and reduced coordination of the muscles in the mouth and pharynx).
- Communication: when a person is injured in the left side of the brain where the language center is located (this will be reflected in the right side of the body), he or she may suffer from impaired speech and language skills (aphasia). Aphasia is language impairment leading to reduced communication and auditory understanding on a daily level. In this case the intellectual ability can be maintained, but the patient loses (fully or partially) his or her ability to use language, express their wishes through speech, understand spoken language, read and write. The difficulty can be reflected in expressing supposedly simple ideas such as hunger, attempting to remember the names of close relatives, etc. Sometimes the difficulty only involves the motorics of speech (dysartharia), which leads to difficulty in pronouncing sounds, making the person’s speech impaired, slow and unclear.
- Swallowing: swallowing disorders (dysphagia) are reflected in actual difficulty to swallow due to impaired function of the chewing organs (lips, tongue, palate) or in impaired stimulation of the swallowing reflex. These difficulties can be identified by coughs or throat clearing when swallowing. Failure to diagnose and treat these conditions can lead to pneumonia caused by inhaling food to the lungs (aspiration).
- Sensation: reduced sensation in various parts of the body can be experienced. Some patients can suffer pain, numbness or unusual sensations. These can stem from various reasons, including damage to the sensation area in the brain, joint stiffness or a handicapped limb. Another, less common type of pain is called “central pain syndrome”, caused by damage to an area of the brain known as the thalamus. In this case the pain is a combination of sensations including cold, heat, a burning sensation, numbness and tingling. It focuses mainly in the limbs and tends to worsen between seasons. Sometimes, bedsores can develop as a result of prolonged motionless sitting or lying. Pulling on the weak, injured arm can injure the shoulder joint and lead to intense pain.
- Spatial perception: when a person is injured in the right side of the brain (i.e., the left side of the body), a phenomenon known as “neglect” can occur. As a result of the stroke, the patient becomes unaware of one side of the body, thus unable to identify or react to significant stimuli in one side of their field of vision. A patient with neglect is unaware of his or her condition, and is subject to household accidents or even car accidents if holding a driver’s license.
- Thinking: a stroke can lead to difficulty in time and place orientation, and in recognizing people (the person’s children or spouse). The patient can even experience difficulties in concentration, understanding, thinking, memory, basic judgment and planning supposedly simple actions. Many of these changes can be improved by appropriate rehabilitation.
- Behavior: passiveness or in fact over activity and aggressiveness can manifest themselves, as well as incorrect judgment that may lead to inappropriate decisions contrary to any acceptable or past logic.
- Emotion: difficulty to control emotions may appear, or the expression of emotions unsuitable to the person’s circumstances. The most common problems after a stroke are depression and anxiety. Depression may occur as a reaction to the changes caused by the stroke and/or due to the location of the damage to the brain (in an area monitoring emotion).