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.
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.
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.
Medications
Medicines may be given right away for an ischemic stroke to:
- Dissolve clots and prevent new ones from forming
- Thin blood
- Control blood pressure
- Reduce brain swelling
- Treat an irregular heart rate
Cholesterol medicines called statins may also be given.
For a hemorrhagic stroke, the doctor may give medicines to:
- Work against any blood-thinning drugs that you may regularly take
- Reduce how your brain reacts to bleeding
- Control blood pressure
- Prevent seizures
Surgery
For an ischemic stroke, procedures may be done to:
- Reroute blood supply around a blocked artery
- Remove the clot or deliver clot-dissolving medicine (embolectomy)
- Remove fatty deposits from a carotid artery (major arteries in the neck that lead to the brain) ( carotid artery endarterectomy )
- Widen carotid artery and add a mesh tube to keep it open ( angioplasty and stenting )
For a hemorrhagic stroke, the doctor may:
- Remove a piece of the skull ( craniotomy ) to relieve pressure on the brain and remove blood clot
- Place a clip on or a tiny coil in the 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
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 .