Strokes create disability more often than any other cause in the United States, and are the third leading cause of death. During a stroke, oxygen is prevented from reaching the neurons in parts of the brain, causing trauma and possibly killing the neurons. Strokes happen in one of two basic ways. One is an ischemic blood clot, accounting for about 83 percent of all strokes. In this type of stroke, a blood clot travels into an artery feeding the brain, causing an obstruction of blood flow, and therefore oxygen, past that point. Hemorrhagic strokes are the second type. With a hemorraghic stroke, blood flows out of the arteries directly into the brain, severely damaging the neurons. Aneurysms and arteriovenous malformations (AVMs, or congenital structural abnormalities in brain arteries) create hemorraghic strokes. Each human has a brain that works much the same as everyone else's. A car is a car is a car, not a bicycle, whatever the model. We share basic brain structures that enable us all to experience the world in a similar manner. For example, we are able to differentiate colors, feel hot and cold, understand language and feel fear and joy. Our brains are two connected halves, each contributing to our experiences. The right brain governs in-the-moment experience, allowing us to remember in detail an emotionally charged scene. For instance, the circumstances, smells and sounds of a car crash, or the birth of a child, will stay with us long after the event. The left brain is the organizer, the keeper of language and the list-maker. Your right brain that communicates the beauty of a leaf; your left brain reminds you to stop for bread on the way home from work, and also knows your address and the route. A left-brain stroke has different effects than a right-brain stroke. Although no two brains are exactly alike, some general differences between left-brain and right-brain strokes can be determined.
The Left Brain
Physically, the left brain controls the left side of the face and the right side of the body. This is the part of the brain that remembers not only name, address and serial number, but your ATM code, passwords and phone number. Your left brain knows exactly what you mean to include on your next resume, and is the source of the voice in your head that keeps telling you, endlessly, how you are doing with anything you are doing, in great detail. Your left brain is your personal play-by-play announcer, commenting on whether you should have just made that remark to your boss or worn those shoes today. The left brain is linear, methodical and the source of understanding time as past, present and future. Academic success is predicated on the left-brain attributes of creating and remembering patterns, and then applying them to data. Your left brain gives you the ability to use language, written or verbal. It is the source of your perception of yourself as an individual, the source of your ego.
Effects of a Left-Brain Stroke vs. a Right-Brain Stroke
No two brains, or strokes, are exactly alike. Generally, however, a left-brain stroke manifests most obviously in a physical way as paralysis or loss of function on the left side of the face and the right side of the body. Since the left brain processes language, the ability to read, write and speak may be lost or compromised. Memory is affected---in particular, linear memory. A left-brain-stroke survivor might not understand that socks must be put on before shoes. Reasoning that requires an "if this, then that" strategy, as in mathematics or logic, is a common victim of a left-brain stroke. Personal credentials like name, occupation and address, along with all the other data one uses to separate oneself from everyone else, are threatened by a left-brain stroke. In short, a left-brain stroke harms linear, analytic thinking, including language centers, time concepts and one's definition of oneself, as well as leaving a mark on the the right side of the body. A slow, cautious behavioral style may also result. In contrast, a right-brain stroke will physically affect the right side of the face and the left side of the body. Although language centers stay intact, the ability to decode language appropriately in context may be compromised or lost. For example, a common phrase like "Let's go rub elbows" might be taken literally. Vision problems may occur, and a quick, inquisitive behavioral style may result.
Strokes damage or kill brain neurons, which are thought not to regenerate. With an enriched environment, good support and appropriate physical therapy, remaining neurons can take over the jobs of damaged or destroyed neurons. It is a highly individualized process, with many variables in brain wiring from one person to the next. Brains are plastic, and even though dead neurons are not replaced, strides in recovery may continue for years. You may be individually supporting a stroke survivor as a family member or friend; financially; medically; or morally, as a clergy person or social worker. In any role, continue to seek updated information and to take an active part in rehabilitation. The outlook may be brighter than you think, and a caring support team is an important part in rehabilitation. The book "My Stroke of Insight" by Jill Bolte Taylor, a Harvard-educated brain researcher and stroke survivor (2008, Viking), gives a much larger picture of what happens in a stroke and how it feels to the person who had it, and practical tips on how to achieve the most in recovery.
Tips on How to Help a Stroke Survivor
Good assessment of damaged brain areas is key. Different brain regions serve different functions. Knowing the answers to the following seven questions can help pinpoint what brain regions were damaged. 1. Eyes and ears...what can the survivor actually see and hear? 2. Can she discriminate colors? 3. Is there perception of three dimensions? 4. Does he have a sense of time? 5. Does she know that all of her body parts are actually hers? 6. Can he discriminate a voice from background noise? 7. Is there evidence of linear thinking as evidenced by the identification of ordinary objects and the sense that underwear must be put on before overclothes, or that the phone must be dialed before speaking? These are some thoughts for caregivers.
1. Is he too hot or too cold? Thirsty? In pain? 2. For oversensitivity to light or sound, provide earplugs or sunglasses. 3. Speak to her directly, not about her to others. 4. Respect the survivor. There is no need to raise your voice to be heard, or to lose patience at having to repeat yourself. Make eye contact. Be gentle. 5. Foster familiarity with family, friends, coworkers and sources of loving support by keeping photos, cards and other mementos close at hand and visible, preferably labeled. 6. Keep visits short, and limit the access of nervous or agitated friends and family. 7. Sleep is restorative. The stroke survivor needs plenty of it. 6. Love him for who he is today, and support him in his progress toward recovering previous abilities. Believe in the survivor, the plasticity of the brain and its amazing ability to compensate for damage over time.
Warning Signs of Stroke
Learn these warning signs. Any of these symptoms require seeing a doctor quickly, even if the symptom is short-lived.
S=SPEECH, or any problems with language T=TINGLING, or any numbness in the body R=REMEMBER, or any problems with memory O=OFF BALANCE, or problems with coordination K=KILLER HEADACHE E=EYES, or any problem with vision