Left-side Stroke

(Stroke, Left-side; Left Hemisphere Stroke; Stroke, Left Hemisphere)

Definition

The cerebrum is the largest part of the brain. It is made of a left and a right hemisphere. In most people, the left hemisphere is in charge of the functions on the right-side of the body. It is also involved in abilities such as the ability to speak, or use language.
A left-side stroke happens when the blood supply to the left side of the brain is interrupted. Without oxygen and nutrients from blood, the brain tissue quickly dies.
cerebrum
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There are two main types of stroke: ischemic and hemorrhagic. An ischemic stroke is the most common type of stroke.

Causes

An ischemic stroke is caused by a blockage of the blood flow, which may be due to:
  • A clot from another part of the body like the heart or neck. The clot breaks off and flows through the blood until it becomes trapped in a blood vessel supplying the brain.
  • A clot that forms in an artery that supplies blood to the brain.
  • A tear in an artery supplying blood to the brain. Called an arterial dissection.
A hemorrhagic stroke is caused by a burst blood vessel. Blood spills out of the broken blood vessel and pools in the brain. This interrupts the flow of blood and causes a build up of pressure on the brain.
Hemorrhagic vs. Ischemic Stroke
factsheet image
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Risk Factors

Certain factors increase your risk of stroke but can not be changed, such as:
  • Race—People of African American, Hispanic, or Asian/Pacific Islander descent are at increased risk.
  • Age: Older than 55 years of age
  • Family history of stroke
Other factors that may increase your risk can be changed such as:
Certain medical condition that can increase your risk of stroke. Management or prevention of these conditions can significantly decrease your risk. Medical conditions include:
Risk factors specific to women include:
  • Previous pre-eclampsia
  • Use of birth control pills, especially if you are over 35 years old and smoke
  • Long-term use of hormone replacement therapy
  • Menopause
  • Pregnancy—due to increased risk of blood clots

Symptoms

Symptoms occur suddenly. Exact symptoms will depend on the part of the brain affected. Rapid treatment is important to decrease the amount of brain damage. Brain tissue without blood flow dies quickly.
Call for emergency medical help right away if you notice any of the following:
  • Sudden weakness or numbness of face, arm, or leg, especially on the right side of the body
  • Sudden confusion
  • Sudden trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden lightheadedness, trouble walking, loss of balance, or coordination
  • Sudden severe headache with no known cause
If you or someone you know has any of these symptoms, call for emergency medical services right away. Brain tissue without blood flow dies quickly. Early care can decrease damage.
Longer-lasting effects of the stroke may include problems with:
  • Left-sided weakness and/or sensory problems
  • Speaking and swallowing
  • Vision (eg, inability for the brain to take in information from the left visual field)
  • Perception and spatial relations
  • Attention span, comprehension, problem solving, judgment
  • Emotions
  • Interactions with other people
  • Activities of daily living, such as going to the bathroom
  • Mental health, such as depression , frustration, impulsivity

Diagnosis

A physical exam will be done to look for muscle weakness, visual and speech problems, and movement difficulty. If possible, you will be asked about your symptoms and medical history. Your doctor may use a or of the brain to confirm a stroke or rule out other conditions.
Images may be taken of your bodily structures. This can be done with:
Blood tests can also help determine if there is a bleeding problem.

Treatment

Immediate treatment is needed to:
  • Dissolve or remove a clot causing an ischemic stroke
  • Stop the bleeding during a hemorrhagic stroke
Oxygen therapy may be needed.

Medications

For an ischemic stroke, medication may be given to:
  • Dissolve clots and prevent new ones from forming
  • Thin blood
  • Control blood pressure
  • Treat an irregular heart rate
  • Treat high cholesterol
For a hemorrhagic stroke, the doctor may give medication to:
  • Work against any blood-thinning drugs you may regularly take
  • Prevent seizures
  • Reduce how your brain reacts to bleeding
  • Control blood pressure

Surgery

For an ischemic stroke, procedures may be done to:
For a hemorrhagic stroke, the doctor may:
  • Remove a piece of the skull to relieve pressure on the brain ( craniotomy )
  • Place a clip or a tiny coil in an aneurysm to stop it from bleeding

Rehabilitation

A rehabilitation program focuses on:
  • Physical therapy—to regain as much movement as possible
  • Occupational therapy—to assist in everyday tasks and self-care
  • Speech therapy—to improve swallowing and speech challenges
  • Psychological therapy—to help adjust to life after the stroke

Prevention

Many of the risk factors for stroke can be changed. Lifestyle changes that can help reduce your chance of getting a stroke include:
  • Exercise regularly.
  • Eat more fruits, vegetables , and whole grains . Limit dietary salt and fat .
  • If you smoke, talk to your doctor about ways to quit.
  • Increase your consumption of fish.
  • Drink alcohol only in moderation. This means 1-2 drinks per day.
  • Maintain a healthy weight.
  • Check your blood pressure frequently . Follow your doctor's recommendations for keeping it in a safe range.
  • Take aspirin if your doctor says it is safe.
  • Keep chronic medical conditions under control. This includes high cholesterol and diabetes.
  • Talk to your doctor about the use of statins. These types of drugs may help prevent certain kinds of strokes in some people.
  • Seek medical care if you have symptoms of a stroke, even if symptoms stop.
  • If you use drugs, talk to your doctor about rehabilitation programs.

RESOURCES

American Heart Association http://www.heart.org

National Stroke Association http://www.stroke.org

CANADIAN RESOURCES

Health Canada http://www.hc-sc.gc.ca

Heart and Stroke Foundation http://www.heartandstroke.com

References

Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2010 October 21.

Hemorrhagic stroke. National Stroke Association website. Available at: http://www.stroke.org/understand-stroke/what-stroke/hemorrhagic-stroke. Accessed November 18, 2014.

Hemorrhagic strokes (bleeds). American Heart Association American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/Hemorrhagic-Strokes-Bleeds%5FUCM%5F310940%5FArticle.jsp. Updated September 16, 2014. Accessed November 18, 2014.

Intracerebral hemorrhage. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 6, 2014. Accessed November 18, 2014.

Ischemic strokes (clots). American Heart Association American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Strokes-Clots%5FUCM%5F310939%5FArticle.jsp. Updated August 29, 2014. Accessed November 18, 2014.

Long term management of stroke. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 30, 2014. Accessed November 18, 2014.

Mena F, Fruns M, Contreras A, Soto F, Mena I. Acute brainstem infarct: multidisciplinary management. Alasbimn Journal website. Available at: http://www.alasbimnjournal.cl/revistas/5/mena5.htm. Published October 1999. Accessed November 18, 2014.

Nueroimaging for acute stroke. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 14, 2014. Accessed November 18, 2014.

Raychev R, Saver JL. Mechanical thrombectomy devices for treatment of stroke. Neurol Clin Practice. 2012;2(3):231-235.

Recognizing stroke. National Stroke Association website. Available at: http://www.stroke.org/site/PageServer?pagename=SYMP. Accessed November 18, 2014.

Stroke (acute management). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 17, 2014. Accessed November 18, 2014.

Subarachnoid hemorrhage. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 28, 2014. Accessed November 18, 2014.

2/7/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/: Bushnell C, et al. AHA/ASA Guideline for the Prevention of Stroke in Women. Stroke. 2014 Feb 6. [Epub ahead of print]

6/2/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Myint PK, Cleark AB, et al. Bone mineral density and incidence of stroke: European prospective investigation into cancer-norfolk population-based study, systemic review, and meta-analysis. Stroke. 2014 Feb;45(2):373-82.

6/2/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Imfeld P, Bodmer M, et al. Risk of incident stroke in patients with Alzheimer disease or vascular dementia. Neurology. 2013 Sep 3;81(10):910-919.

Revision Information

  • Reviewer: Rimas Lukas, MD
  • Review Date: 11/2014 -
  • Update Date: 06/02/2014 -