Health Library

Right-side Stroke

(Stroke, Right-side; Right Hemisphere Stroke; Stroke, Right Hemisphere)

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.

Hemorrhagic vs. Ischemic Stroke

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.

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

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

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.

American Heart Association

http://www.heart.org/HEARTORG/

National Stroke Association

http://www.stroke.org/

Health Canada

http://www.hc-sc.gc.ca/index-eng.php

Heart and Stroke Foundation of Canada

http://www.heartandstroke.com/

Stroke Survivors

Association of Ottawa

http://www.strokesurvivors.ca/

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Last reviewed June 2012 by Rimas Lukas, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.