Right-side Stroke

Definition

The cerebrum, the largest part of the brain, is separated into the right and left hemispheres. The right hemisphere is in charge of the functions on the left-side of the body, as well as many cognitive functions.

A right-side stroke happens when the brain’s blood supply is interrupted in this area. Without oxygen and nutrients from blood, the brain tissue quickly dies. A stroke is a serious condition. It requires emergency care.

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Causes

There are two main types of stroke:

• Ischemic
• Hemorrhagic

An ischemic stroke (the more common form) is caused by a sudden decrease in blood flow to a region of the brain, which may be due to:

• A clot that forms in another part of the body (eg, heart or neck) breaking off and blocking the flow in a blood vessel supplying the brain (embolus)
• A clot that forms in an artery that supplies blood to the brain (thrombus)
• A tear in an artery supplying blood to the brain (arterial dissection)

A hemorrhagic stroke is caused by a burst blood vessel that results in bleeding in the brain.

Hemorrhagic vs. Ischemic Stroke

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Risk Factors

Examples of risk factors that you can control or treat include:

• Certain conditions, such as:
  • High blood pressure
  • High cholesterol
  • High levels of the amino acid homocysteine (may result in the formation of blood clots)
  • Atherosclerosis (narrowing of the arteries due to build-up of plaque)
  • Atrial fibrillation (abnormal heart rhythm)
  • Obesity
  • Metabolic syndrome
  • Type 2 diabetes
  • Alcohol or drug abuse
• Medicines (eg, long-term use of birth control pills)
• Lifestyle factors (eg, smoking, physical inactivity, diet)

Risk factors that you cannot control include:

• History of having a stroke, heart attack, or other type of cardiovascular disease
• History of having a transient ischemic attack (TIA)—With a TIA, stroke-like symptoms often resolve within minutes (always in 24 hours). They may signal a very high risk of having a stroke in the future.
• Age: 60 or older
• Family members who have had a stroke
• Gender: males
• Race: Black, Asian, Hispanic
• Blood disorder that increases clotting
• Heart valve disease (eg, mitral stenosis)

Symptoms

The immediate symptoms of a right-side stroke come on suddenly and may include:

• Weakness or numbness of face, arm, or leg, especially on the left side of the body
• Confusion
• Dizziness
• Loss of balance, coordination problems
• Vision problems, especially on the left-side of vision in both eyes
• Difficulty swallowing
• Headache

If you or someone you know has any of these symptoms, call 911 right away. A stroke needs to be treated as soon as possible.

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 (eg, going to the bathroom)
• Mental health (eg, depression, frustration, impulsivity)

Diagnosis

The doctor will make a diagnosis as quickly as possible. Tests may include:

• Exam of nervous system
• Computed tomography (CT) scan —a type of x-ray that uses a computer to make pictures of the brain
• CT angiogram—a type of CT scan which evaluates the blood vessels in the brain and/or neck
• Magnetic resonance imaging (MRI) scan —a test that uses magnetic waves to make pictures of the brain
• Magnetic resonance angiography (MRA) scan —a type of MRI scan which evaluates the blood vessels in the brain and/or neck
• Angiogram —a test that uses a catheter (tube) and x-ray machine to assess the heart and its blood supply
• Heart function tests (eg, electrocardiogram, echocardiogram)
• Doppler ultrasound —a test that uses sound waves to examine the blood vessels
• Blood tests
• Tests to check the level of oxygen in the blood
• Kidney function tests
• Tests to evaluate the ability to swallow

Treatment

Immediate treatment is needed to potentially:

• Dissolve a clot causing an ischemic stroke
• Stop the bleeding during a hemorrhagic stroke

In some cases, oxygen therapy is needed.

Prevention

To help reduce your chance of having a stroke, take the following steps:

• Exercise regularly.
• Eat a healthy diet that includes fruit, vegetables, whole grains, and fish.
• Maintain a healthy weight.
• If you drink alcohol, drink only in moderation (1-2 drinks per day).
• If you smoke, quit.
• If you have a chronic condition, like high blood pressure or diabetes, get proper treatment.
• If recommended by your doctor, take a low-dose aspirin every day.
• If you are at risk for having a stroke, talk to your doctor about taking statin medicines.