Left side Stroke

Overview

Definition

The cerebrum is the largest part of the brain. It is made of a left and a right section. The left side of the brain is in charge of the right side of the body. In most people, it is also controls the ability to speak, or use language.

A left brain stroke happens when the blood supply to the left side of the brain is interrupted. Blood brings oxygen and nutrients to brain tissue. When blood flow is stopped, the brain tissue quickly dies.

cerebrum
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There are 2 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 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—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
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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:

  • Drug abuse from cocaine , amphetamines, or heroin use
  • Smoking
  • Physical inactivity

Certain medical condition that can increase your risk of stroke. Management or prevention of these conditions can significantly decrease your risk. Medical conditions include:

  • High blood pressure
  • High cholesterol levels —specifically high-LDL cholesterol
  • Low bone mineral density, especially in women
  • Obesity and metabolic syndrome
  • Sleep apnea
  • High blood homocysteine level
  • Atherosclerosis
  • Type 2 diabetes or impaired glucose tolerance
  • Atrial fibrillation
  • Blood disorders such as sickle cell disease and polycythemia
  • Vascular dementia
  • Disease of heart valves, such as mitral stenosis
  • Prior stroke or cardiovascular disease, such as heart attack
  • Peripheral artery disease
  • Transient ischemic attack (TIA)—a warning stroke with stroke-like symptoms that go away shortly after they appear
  • Conditions that increase your risk of blood clots such as:
    • Cancer
    • Certain autoimmune diseases
  • Migraine with aura
  • Having a blood vessel abnormality
  • Psychological disorders, such as depression or anxiety

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

SymptomsandDiagnosis

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—aphasia
  • Sudden trouble seeing the right side of the world from both eyes—homonymous hemianopsia
  • Sudden lightheadedness, trouble walking, loss of balance, or coordination
  • Sudden severe headache with no known cause

Longer-lasting effects of the stroke may include problems with:

  • Left-sided weakness and/or sensory problems
  • Speaking and swallowing
  • Vision, like the 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

You will be asked about your symptoms and past health. A physical exam will be done to look for muscle weakness and movement difficulty. Vision and speech will also be checked.

Images may be taken of your bodily structures. This can be done with:

  • CT scan
  • MRI scan
  • Magnetic resonance angiography (MRA)
  • CT angiogram (CTA)
  • Doppler ultrasound

Blood tests can also help determine if there is a bleeding problem.

Treatments

Treatment

Immediate treatment is needed to:

  • Dissolve or remove a clot causing an ischemic stroke
  • Remove clots from blood vessels using special devices
  • 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 the 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:

  • Reroute blood supply around a blocked artery
  • Remove the clot or deliver clot-dissolving medication
  • Remove fatty deposits from arteries in the neck—carotid endarterectomy
  • Widen the carotid artery and add a mesh tube to keep it open—atherectomy of noncoronary vessel

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.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Edits to original content made by Denver Health.

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

RESOURCES

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

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

CANADIAN RESOURCES

Health Canada https://www.canada.ca 

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

References

Cassella CR, Jagoda A. Ischemic stroke: advances in diagnosis and management. Emerg Med Clin North Am. 2017;35(4):911-930.

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. 2011;42(1):227-276.

Hemorrhagic stroke. National Stroke Association website. Available at: http://www.stroke.org/understand-stroke/what-stroke/hemorrhagic-stroke. Accessed November 8, 2018.

Hemorrhagic strokes (bleeds). American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/Hemorrhagic-Strokes-Bleeds%5FUCM%5F310940%5FArticle.jsp#.Vk3h%5Fk2FPIU. Updated April 26, 2017. Accessed November 8, 2018.

Intracerebral hemorrhage. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T115590/Intracerebral-hemorrhage . Updated November 28, 2018. Accessed December 11, 2018.

Ischemic strokes (clots). American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Strokes-Clots%5FUCM%5F310939%5FArticle.jsp#.Vk3ipE2FPIU. Updated April 26, 2017. Accessed November 8, 2018.

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Neuroimaging for acute stroke. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T474350/Neuroimaging-for-acute-stroke . Updated April 13, 2018. Accessed December 11, 2018.

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Subarachnoid hemorrhage. EBSCO DynaMed Plus website. Available at:  http://www.dynamed.com/topics/dmp~AN~T116453/Subarachnoid-hemorrhage . Updated June 6, 2018. Accessed December 11, 2018.

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