The Days and Months After a Stroke

Problems that Occur After a Stroke

There are many problems that may happen after a stroke. Most are common and will improve with time and rehabilitation.

Common physical conditions after a stroke include:

  • Weakness, paralysis, and problems with balance or coordination.
  • Pain, numbness, or burning and tingling sensations.
  • Fatigue, which may continue after you return home.
  • Inattention to one side of the body, also known as neglect; in extreme cases, you may not be aware of your arm or leg.
  • Urinary or bowel incontinence.
  • Speech problems or difficulty understanding speech, reading, or writing.
  • Difficulty swallowing.
  • Memory problems, poor attention span, or difficulty solving problems.
  • Visual problems.
  • Depression, anxiety, or mood swings with emotional outbursts.
  • Difficulty recognizing limitations caused by the stroke.

Right vs. Left Side of the Brain

Common problems when a stroke happens on the right side of the brain versus the left side of the brain:

Right Side of the Brain Left Side of the Brain
  • Left-side weakness
  • Impulsive behavior
  • Overconfidence in abilities
  • Vision problems
  • Right-side weakness
  • Speech and language problems
  • Slow behavior

Special Problems

You may need focused treatment to address certain other conditions.

Shoulder/hand syndrome

Shoulder/hand syndrome happens when the loss of a muscle group causes the shoulder to detach from its socket.

The secondary disability may include:

  • Tingling
  • Varying feelings of hot and cold
  • Changes in sensation

Preventing and treating the syndrome is critical in the rehabilitation process. It can be addressed with range of motion exercises.

Learned non-use

A phenomenon often seen in people after having a stroke is “learned non-use.” This occurs when you accept the loss of function of a particular muscle or muscle group and only uses your “good side.”

Treatment for this condition consists of advanced therapy that allows the brain to “re-wire” connections to help regain function and movement.

Spasticity

Spasticity is a frequent outcome of stroke. 

Your limbs may change position; your neck, arms, or legs can get stiff, painful, or shorten, limiting mobility and interfering with activities of daily living.

With specialized and individualized treatment at the UPMC Rehabilitation Institute, quality of life can be improved.

In addition to traditional medicines, we offer treatments for spasticity, including:

  • Phenol: A type of alcohol proven to prevent the transmission of excess nerve impulses when used in small amounts. It can allow for excellent spasticity control, especially in the elbow and thigh muscles.
  • Lioresal (baclofen): This medicine can be very effective in severe cases of spasticity. It's most effective when given through a surgically implanted pump, which allows for very low doses and minimal side effects.
  • Botulinum toxin injections: This can be very successful for treating spastic muscles, when used in small amounts.

Communication Problems After a Stroke

Communication problems after a stroke may involve:

  • Speech disorders
  • Language disorders
  • Cognitive-linguistic deficits
  • A combination of any or all of the above

The speech-language pathologist at the UPMC Rehabilitation Institute evaluates and provides treatment for these problems.

Type Description
Speech Disorders
  • Dysarthia — A collective term used to describe speech changes caused by any of the following:
    • Muscle weakness
    • Incoordination
    • Increased muscle tone
    • Presence of involuntary movements
    • Muscle stiffness
  • Apraxia of speech — A specific type of neurologically based speech change that happens because of the brain’s inability to provide normal sensory and motor control of the:
    • Jaw
    • Lips
    • Tongue
    • Soft palate
    • Vocal cords
Language Disorder
  • Aphasia — A disorder of language processing that happens because of damage to the brain. Aphasia can be very frustrating for you and your caregivers. It's like trying to learn and use a foreign language when living in a foreign country.
  • Aphasia affects your abilities to:
    • Understand spoken and written words and sentences
    • Recall words
    • Formulate sentences
  • It does not affect your:
    • Level of intelligence
    • Ability to think
    • Ability to hear
Cognitive-Linguistic Deficits
  • Deficits may include:
    • Attention
    • Memory
    • Social skills
    • Thinking
    • Visual processing abilities

 
Depression and Emotional Changes After a Stroke

Depression is a frequent problem after a stroke.

Physical and psychological symptoms can include:

  • Sudden mood changes
  • Feeling anxious, worried, pessimistic, or hopeless
  • Having thoughts of death
  • Loss of energy
  • Increase or decrease in appetite
  • Difficulty sleeping or sleeping too much
  • Difficulty concentrating, remembering, thinking, or making decisions
  • Headache
  • Digestive problems
  • Sexual problems

Talk your doctor if you have concerns about depression. Antidepressant medicine may be available, or it may be better to get a referral for a psychologist or psychiatrist.

Increasing the amount of socialization with other stroke patients may also help improve mood.

Contact Us

Call 1-877-AT-REHAB
(28-73422) to learn more about our stroke rehabilitation program or to refer a patient.

Our Experts

©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com