Symptoms of a right hemisphere stroke

Pro Research Analysisby

Searched over 200M research papers

Analyzed relevant papers

Symptoms of a Right Hemisphere Stroke

Hemiparesis and Hemianopia

One of the most common symptoms of a right hemisphere stroke is hemiparesis, which is the weakness of one side of the body, typically the left side. This condition often accompanies hemianopia, a loss of vision in half of the visual field in each eye.

Neglect and Extinction

Patients with right hemisphere strokes frequently exhibit neglect, particularly left-sided neglect, where they fail to attend to the left side of their environment. This can manifest in various ways, such as ignoring food on the left side of a plate or failing to dress the left side of the body. Extinction, a related phenomenon, occurs when patients fail to recognize stimuli on the left side when presented simultaneously with stimuli on the right side .

Constructional and Dressing Apraxia

Constructional apraxia, the inability to construct or draw objects, is another symptom associated with right hemisphere strokes. This condition is often linked to unilateral spatial neglect on drawing (USND). Dressing apraxia, the difficulty in dressing oneself, is also observed and is related to the spatial and motor planning deficits caused by the stroke.

Anosognosia and Motor Impersistence

Anosognosia, a lack of awareness or denial of the severity of one's own condition, is common in right hemisphere stroke patients. Motor impersistence, the inability to sustain a motor action, is also frequently observed. Both conditions tend to occur with larger strokes and are often associated with damage to the right parietal lobe and other adjacent structures.

Delirium

Delirium, characterized by inattention, cognitive fluctuation, disorganized thinking, and altered levels of consciousness, is prevalent in right hemisphere stroke patients. Studies have shown that about 26% of patients with acute right hemisphere strokes experience delirium, which underscores the importance of routine delirium screening in these patients.

Dysfluency and Dysarthria

Right hemisphere strokes can lead to severe dysfluency, including stuttering characterized by phoneme and syllable reiterations. Dysarthria, a motor speech disorder resulting in slurred speech, is also common. These speech issues are often due to lesions in the right frontal operculum and other related areas .

Hypergraphia

Hypergraphia, a condition where patients produce excessive and often semantically loose writing, has been reported in some right hemisphere stroke patients. This behavior is typically initiated by subtle prompts and continues semi-automatically.

Depression and Cognitive Deficits

Depressive symptoms are common in right hemisphere stroke patients and can exacerbate cognitive deficits. These deficits span various domains, including attention, memory, language, and visuospatial skills. The presence of depression can significantly impair cognitive performance, highlighting the need for comprehensive neuropsychological assessments in these patients.

Apraxia and Visuospatial Deficits

Apraxia, particularly the imitation of meaningless postures and pantomime of tool use, is frequently observed in right hemisphere stroke patients. These deficits are often associated with neglect and are linked to lesions in the temporal, parietal, and occipital lobes. The presence of neglect can further complicate these apraxic symptoms, leading to significant functional impairments.

Conclusion

Right hemisphere strokes result in a diverse array of symptoms, including motor and sensory deficits, cognitive and behavioral abnormalities, and speech and language issues. Understanding these symptoms is crucial for effective diagnosis, management, and rehabilitation of affected patients. Comprehensive assessments and targeted interventions can help mitigate the impact of these symptoms and improve patient outcomes.