A stroke can result in behavioral changes.

These changes can vary and are based on the strokes severity and the
part of the brain in which the stroke takes place.
The largest portion of the brainthe cerebral cortexhas two hemispheres. The right hemisphere of the brain
controls nonverbal communication, emotions and spatial orientation or sense of body position. The left hemisphere of
the brain controls the right side of the body and is the brains language center. The left hemisphere also is largely
responsible for analytical thinking.

Right-brain injury
Damage to this side of the brain can cause a range of problems in a persons emotions and behavior. A stroke
survivor with right-brain injury may be unaware of his or her impairment and be certain that he or she can perform the
same tasks as before the stroke. This individual also may experience emotional lability, poor judgment, short attention
span and short-term memory loss.
Often, the spatial-perceptual difficulties involved in right-brain injuries are overlooked. When individuals with rightbrain injuries have problems performing simple activities, these individuals may be seen as uncooperative, confused,
overly dependent or unmotivated.
Caregivers can take steps to help stroke survivors deal with limitations of right-brain injury once those limitations are
realized. If you are a stroke survivor with a right-brain injury, it is important that you are aware of potential dangers in
your environment. The following are some tips:
For stroke survivors with right-brain injury, it is important to:

Keep a safe environment. All items that have the potential to be dangerous (e.g., poisons,
cleaning chemicals and sharp objects) should be kept in a safe place.
Remember to scan (turn your head from side to side) in order to see what would usually be
ignored on the affected side.
Acknowledge the affected part of your body as still a part of you. Remember the affected side
of your body by touching it or rubbing it.
Dont try to handle all activities alone. Ask for help if you are in a situation where you may
become injured or confused.
Encourage caregivers to be sensitive to your visual and sensory difficulties. For instance, make
sure that caregivers place items that you may need on your right side if you cannot perceive things on
your left side.
Minimize environmental clutter and distractions. Too much visual or auditory stimulation in
your environment may be dangerous and may add to your confusion. Calm and quiet surroundings can
help you focus on a given task.
Help prevent injuries that may result from your inability to determine depth and distance. Make
sure that pointed edges on things such as furniture and doorways are clearly marked.
Stroke survivors with right-brain injuries frequently have speech and communication problems. Many of these
individuals have a hard time pronouncing speech sounds properly because of the weakness or lack of control in the
muscles of the mouth and face. In addition, survivors may have difficulty interacting normally because of problems
with their thinking skills.
A speech/language therapist can assist the survivor and family members in dealing with communication problems.

Left-brain injury
Left-brain stroke survivors may experience personality changes, communication problems and some paralysis on the
right side. Survivors with left-brain damageunlike those with right-brain damagetend to behave in a cautious,
compulsive, or disorganized way and are easily frustrated. People with left-brain injury may be slow to take action or
to respond to questions.
The behavior and mood changes linked to left-brain injury can be frustrating to the survivor as well as to the
caregiver. In assisting the survivor in his or her attempts to perform as normally as possible, it is important for the
caregiver to:

Develop strategies permitting the survivor to function at a comfortable pace. The organization
of daily routines and schedules needs to be done with care.
Recognize and address fatigue. Fatigue can be a roadblock to recovery. Encourage the survivor
to ask for help or to delegate duties.
Be patient. Do not try to rush the survivor into a response to your questions or comments.
Resist the temptation to answer for him or her.
Unless you are aware that the survivor has a hearing problem, speak in a normal voice.
Give immediate and frequent feedback to the survivor in the form of words or by non-verbal
gestures.
State questions so that the survivor can give a yes or no answer. Keep comments simple.

Location of Strokes Left-brain vs. Right-brain Strokes Effects of the stroke that you
had are due to the site of the stroke in the brain. This can be talked about in
different ways. Left-brain vs. right-brain strokes Brain lobe(s) or part involved
(Health Facts for You # 5593) Blood vessel(s) involved (Health Facts for You
#6846) Left-brain vs. right-brain is a simple way of talking about your stroke. Your
doctor can talk with you about your stroke in other ways (see HFFY #5593 and
#6846). Right-Brain Stroke Affects the Left Side of the Body Trouble knowing
how far or near an object is to the body. Neglect of left side of the body, or not
able to see things to the left of the body. Poor decision making, lack of insight
into the changes in ability since the stroke, leading to safety concerns.
Impulsiveness Short attention span and slowed learning of new things. Facial
weakness, unclear speech, or problems swallowing. The right half (hemisphere) of
the brain controls the movement of the left side of the body. A person with a right
brain stroke may not be able to move the left side of the body (hemiplegia) or may
be very weak in the left arm or leg (hemiparesis). The right half of the brain controls
judging distance, size, speed, and position. This may cause a person with a right
brain stroke to misjudge distances leading to falls. The person may not be able to
control the hand to pick up an object. Survivors of right-brain strokes often have
problems making good decisions.

These patients often become impulsive. Persons with right brain stroke are often
unaware of the changes that have happened to them. They believe they can do the
same tasks as they did before the stroke. People with right brain strokes may also
have left-sided neglect. Due to visual field changes, left-sided neglect causes the
person to forget or ignore objects or people on the left side. Some people with
right brain strokes will have issues with short-term memory. Although the person
may be able to tell you about an event that happened 20 years ago, they may not
be able to tell you whom they spoke with that morning or what they had for
breakfast. Left-Brain Stroke Affects the Right Side of the Body Trouble speaking

or understanding words said or written (aphasia see HFFY #6678). Slow, careful
movements. Not able to see things on the right side of the body. Facial
weakness, unclear speech, or problems with swallowing The left half (hemisphere)
of the brain controls the right side of the body. A person with a left brain stroke may
not be able to move the right side of the body, (hemiplegia) or may be very weak in
the right arm or leg (hemiparesis). The left half of the brain controls speech and
language for most people. Someone who has had a left brain stroke may also have
trouble speaking or understanding what is being said to them (aphasia.) Persons
with left brain stroke often are slow and careful. It may take many verbal cues and a
lot of extra time to get something done. Persons with left brain stroke may now
have trouble remembering or learning new things.