After a stroke, there often occur some physical changes, including:
Weakness or paralysis on one side of the body.
If the stroke occurs on the brain's right side, the left side of the body and face will be affected. It's the opposite for a stroke that occurs on the left side of the brain.
After a stroke, it's common to feel tired at some point. This is known as fatigue. Fatigue often starts to lessen a few months after the stroke. But for some people, tiredness may continue for years. If you’re experiencing poststroke fatigue, talk to your health care team about ways to reduce it.
When you try to move a limb, the muscles contract (shorten or flex). This creates stiffness and tightness, which is referred to as "spasticity." Spasticity also causes the tendons and soft tissue around the muscle to become tight or stiff. This makes stretching the muscle much more difficult. If not treated, the muscle can freeze into an abnormal and often painful position. If you have spasticity, talk to your doctor about the best treatments for you. Physical therapy and medications can help.
Seizures are brain malfunctions that alter a person’s awareness. A seizure may last only a few seconds or minutes. It may trigger involuntary body movements, strange sensations or blackouts. Studies vary greatly about how often seizures happen after stroke. Seizures are painless. But they can be upsetting and disorienting. Often, seizures can be treated with medications. If you think you may have had a seizure, let your health care team know.
Communication and Cognitive Changes
Common communication and cognitive changes after a stroke include:
Aphasia is a common communication problem after a stroke. There are three types: expressive, receptive and global.
• People with expressive (non-fluent) aphasia know what they want to say but have trouble saying it. They can't find the right words or have trouble "getting the words out." Or, they may use the wrong words or leave out words without knowing it.
• People with receptive (fluent) aphasia have trouble understanding words other people speak. They may not understand the order of the words or the relationship between the words.
• People with global aphasia may be unable to speak, name objects, repeat phrases or follow commands. They also have a hard time understanding what others are saying.
Dysarthria affects control of the muscles in the face, tongue and mouth. People with dysarthria may know exactly what they want to say. But they may speak slowly. Their speech may sound slurred, muffled, hoarse or nasal.
Apraxia of speech affects the ability to speak. People with apraxia have trouble connecting speech messages from their brain to their mouth. Apraxia of speech may affect more than the power to speak. It often affects reading and writing as well.
Aphasia, dysarthria and apraxia do not cause a loss of intellect. Even though it's difficult for a survivor to speak, it's not because of a lack of intelligence.
Memory and Cognitive Challenges
Different parts of the brain control specific types of thinking. Depending on where stroke happens in the brain, problems with certain types of thought may occur. Stroke survivors can have trouble with memory. Planning, organizing ideas or making decisions can also be hard after stroke.
How stroke affects memory Many stroke survivors face memory challenges. But not all memory problems are the same. A stroke survivor may:
• Remember for only a short span of time. For instance, they might remember only two or three steps in a set of instructions. Or, the person might forget whether they have taken their medications or eaten a meal.
• Have trouble absorbing new information. The survivor may need to have things repeated over and over.
• Have problems transferring learning from one setting to another. For example, in the hospital the survivor might be able to safely transfer from a wheelchair to a bed alone. But at home, the change in setting may make the person unable to do the same task.
• Mix up the details of an event. A stroke survivor might confuse when things happened or who was there. For example, he or she might think a family member visited in the morning instead of the evening before.