Stroke Location and Presentation Flashcards
(24 cards)
What are the key symptoms of a right hemisphere stroke?
Left-sided motor/sensory deficits + Left-sided neglect (with preserved language)
What are the key symptoms of a left hemisphere stroke?
Right-sided motor/sensory deficits + Language problems (aphasia)
Why does a stroke in the right brain cause left-sided symptoms?
Because motor and sensory pathways cross in the brain/brainstem, so right brain damage affects the left side of the body
Why does a stroke in the left brain typically cause language problems?
Because language centers (Broca’s and Wernicke’s areas) are located in the left hemisphere for most people (95% of right-handed and 70% of left-handed people)
What are the typical presentations of a Right PACS (Partial Anterior Circulation Stroke)?
Left-sided weakness/sensory loss + Left-sided neglect + Possible visuospatial problems + Usually preserved language
What are the typical presentations of a Left PACS (Partial Anterior Circulation Stroke)?
Right-sided weakness/sensory loss + Language problems (aphasia) + Usually no neglect
What are the typical presentations of a Right TACS (Total Anterior Circulation Stroke)?
More severe left-sided weakness/sensory loss + Pronounced left neglect + Homonymous hemianopia (left visual field cut) + Visuospatial problems
What are the typical presentations of a Left TACS (Total Anterior Circulation Stroke)?
More severe right-sided weakness/sensory loss + Significant aphasia + Homonymous hemianopia (right visual field cut)
What are the typical presentations of a Right LACS (Lacunar Circulation Stroke)?
Pure left-sided motor and/or sensory deficit + No cortical signs (no neglect, aphasia, or visual field cuts)
What are the typical presentations of a Left LACS (Lacunar Circulation Stroke)?
Pure right-sided motor and/or sensory deficit + No cortical signs (no aphasia or visual field cuts)
What’s the most distinctive feature of a right hemisphere stroke?
Left-sided neglect (patient ignores or is unaware of the left side)
What’s the most distinctive feature of a left hemisphere stroke?
Language problems (aphasia) - difficulty with speech production, comprehension, or both
What assessment would be particularly important for a patient with a right-sided stroke?
Neglect assessment (e.g., line bisection test, clock drawing, cancellation tasks)
What assessment would be particularly important for a patient with a left-sided stroke?
Language assessment (e.g., comprehension, naming, repetition, fluency)
Why might a patient with a right hemisphere stroke underestimate their problems?
Right hemisphere damage can cause anosognosia (lack of awareness of deficits)
What safety concerns might be particularly important for a right hemisphere stroke patient?
Safety concerns related to neglect (bumping into objects on left, not seeing traffic from left, leaving food on left side of plate)
What communication strategies might help a left hemisphere stroke patient?
Simple language, visual cues, writing, gesture, communication boards, allowing time for processing
How might visuospatial problems from a right hemisphere stroke affect daily activities?
Difficulty with navigation, dressing (especially left side), reading (missing left side of pages), driving
How might language problems from a left hemisphere stroke affect daily activities?
Difficulty with communication, reading, writing, using the phone, understanding instructions, social interaction
What type of neglect is most common with right hemisphere strokes?
Left-sided visuospatial neglect (ignoring or being unaware of the left side of space)
What types of aphasia are common with left hemisphere strokes?
Broca’s aphasia (non-fluent, difficulty with speech production), Wernicke’s aphasia (fluent but with comprehension difficulties), or Global aphasia (severe impairment of all language functions)
What emotional changes might be more common with right hemisphere strokes?
Flat affect, indifference, poor awareness of deficits, impulsivity
What emotional changes might be more common with left hemisphere strokes?
Frustration, depression, anxiety related to communication difficulties
In a patient with crossed aphasia, what unusual pattern would you observe?
Language problems (aphasia) after a right hemisphere stroke - a rare condition that occurs in approximately 1-3% of cases
