Complications of Stroke
Cognitive abilities, perception, coordination, speech, and balance can be impaired by a stroke. Paralysis is also possible. The specific effects depend on the location and extent of brain damage. For example, since the right hemisphere of the brain controls movement of the left side of the body, a stroke in the right hemisphere can cause paralysis on the left side of the body. A stroke in the cerebellum can cause problems with balance and coordination, and a brainstem stroke can damage involuntary "life-support" functions such as breathing and heart rate and could lead to death. The five most common complications of stroke that render many patients disabled are aphasia, pain, pseudobulbar affect, vascular dementia, and paralysis/spasticity (NSA 2012c,g,f).
- Aphasia. About 25% of all stroke survivors experience aphasia - impairment of the ability to speak and understand spoken or written language. Aphasia is the result of stroke-induced damage to brain regions involved in speech and language processing. Many patients with aphasia benefit from speech/language therapy (NSA 2012g; Mayo Clinic 2012c).
- Pain. Stroke victims may experience pain immediately following a stroke or weeks to months later. Some stroke victims experience local or mechanical pain that may be isolated to joints. This type of pain is caused by damaged muscle or other soft tissue. Other victims may experience a chronic central pain caused by damage to the brain. Central pain occurs because the damaged brain does not interpret pain messages properly, and may register even the slightest touch as painful (NSA 2012f).
- Pseudobulbar affect. A stroke that damages areas in the brainstem and cerebral cortex can cause a condition called pseudobulbar affect, which results in uncontrollable episodes of laughing or crying - often disrupting normal social interaction. Up to 52% of stroke victims report at least some symptoms of pseudobulbar affect (Rosen 2008; Parvizi 2001).
- Vascular Dementia. It is estimated that almost one-fifth of stroke victims will develop problems with their mental and cognitive abilities (NSA 2012c). This loss of intellectual ability is called vascular dementia and results from tissue damage caused by reduced blood flow to the brain. Evidence suggests that stroke doubles the risk of dementia (Sahathevan 2012). Common symptoms of vascular dementia include memory loss, confusion, and decreased attention span (Pendlebury 2009).
- Paralysis & Spasticity. Some stroke victims experience complete paralysis - the inability to voluntarily move muscles. In other cases, patients may experience a tightening or stiffness of muscles that impairs movement of the arms and/or legs. This condition, called spasticity, occurs because messages from parts of the brain to muscles are not properly conveyed (NSA 2010). In some cases, the damaged brain sends signals to muscles to contract for long periods of time, causing painful muscle spasms similar to severe cramping (Bhakta 2000).