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The Days and Months After a Stroke

Problems that Occur After a Stroke

There are many problems that may happen after a stroke. Most are common and will improve with time and rehabilitation.

Common physical conditions after a stroke include:

  • Weakness, paralysis, and problems with balance or coordination.
  • Pain, numbness, or burning and tingling sensations.
  • Fatigue, which may continue after you return home.
  • Inattention to one side of the body, also known as neglect; in extreme cases, you may not be aware of your arm or leg.
  • Urinary or bowel incontinence.
  • Speech problems or difficulty understanding speech, reading, or writing.
  • Difficulty swallowing.
  • Memory problems, poor attention span, or difficulty solving problems.
  • Visual problems.
  • Depression, anxiety, or mood swings with emotional outbursts.
  • Difficulty recognizing limitations caused by the stroke.

Right vs. Left Side of the Brain

Common problems when a stroke happens on the right side of the brain versus the left side of the brain:

Right Side of the Brain

  • Left-side weakness
  • Impulsive behavior
  • Overconfidence in abilities
  • Vision problems

Left Side of the Brain

  • Right-side weakness
  • Speech and language problems
  • Slow behavior

Special Problems

You may need focused treatment to address certain other conditions.

Shoulder/hand syndrome

Shoulder/hand syndrome happens when the loss of a muscle group causes the shoulder to detach from its socket.

The secondary disability may include:

  • Tingling
  • Varying feelings of hot and cold
  • Changes in sensation

Preventing and treating the syndrome is critical in the rehabilitation process. It can be addressed with range of motion exercises.

Learned non-use

A phenomenon often seen in people after having a stroke is “learned non-use.” This occurs when you accept the loss of function of a particular muscle or muscle group and only uses your “good side.”

Treatment for this condition consists of advanced therapy that allows the brain to “re-wire” connections to help regain function and movement.

Spasticity

Spasticity is a frequent outcome of stroke.

Your limbs may change position; your neck, arms, or legs can get stiff, painful, or shorten, limiting mobility and interfering with activities of daily living.

With specialized and individualized treatment at the UPMC Rehabilitation Institute, quality of life can be improved.

In addition to traditional medicines, we offer treatments for spasticity, including:

  • Phenol: A type of alcohol proven to prevent the transmission of excess nerve impulses when used in small amounts. It can allow for excellent spasticity control, especially in the elbow and thigh muscles.
  • Lioresal (baclofen): This medicine can be very effective in severe cases of spasticity. It's most effective when given through a surgically implanted pump, which allows for very low doses and minimal side effects.
  • Botulinum toxin injections:This can be very successful for treating spastic muscles, when used in small amounts.

Communication Problems After a Stroke

Communication problems after a stroke may involve:

  • Speech disorders
  • Language disorders
  • Cognitive-linguistic deficits
  • A combination of any or all of the above

The speech-language pathologist at the UPMC Rehabilitation Institute evaluates and provides treatment for these problems.

Speech Disorders

  • Dysarthia — A collective term used to describe speech changes caused by any of the following:
    • Muscle weakness
    • Incoordination
    • Increased muscle tone
    • Presence of involuntary movements
    • Muscle stiffness
  • Apraxia of speech — A specific type of neurologically based speech change that happens because of the brain’s inability to provide normal sensory and motor control of the:
    • Jaw
    • Lips
    • Tongue
    • Soft palate
    • Vocal cords

Language Disorder

  • Aphasia — A disorder of language processing that happens because of damage to the brain. Aphasia can be very frustrating for you and your caregivers. It's like trying to learn and use a foreign language when living in a foreign country.
  • Aphasia affects your abilities to:
    • Understand spoken and written words and sentences
    • Recall words
    • Formulate sentences
  • It does not affect your:
    • Level of intelligence
    • Ability to think
    • Ability to hear

Cognitive-Linguistic Deficits

  • Deficits may include:
    • Attention
    • Memory
    • Social skills
    • Thinking
    • Visual processing abilities

Depression and Emotional Changes After a Stroke

Depression is a frequent problem after a stroke.

Physical and psychological symptoms can include:

  • Sudden mood changes
  • Feeling anxious, worried, pessimistic, or hopeless
  • Having thoughts of death
  • Loss of energy
  • Increase or decrease in appetite
  • Difficulty sleeping or sleeping too much
  • Difficulty concentrating, remembering, thinking, or making decisions
  • Headache
  • Digestive problems
  • Sexual problems

Talk your doctor if you have concerns about depression. Antidepressant medicine may be available, or it may be better to get a referral for a psychologist or psychiatrist.

Increasing the amount of socialization with other stroke patients may also help improve mood.

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