Left Hemispheric Stroke

WHAT YOU SHOULD KNOW:

A stroke occurs when blood cannot flow to your brain. The left side (hemisphere) of your brain controls the right side of your body. It also controls your speech and language abilities.


CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

You may get blood clots that can break loose and travel to your lungs or brain. You may have another stroke or go into a coma. You may be paralyzed on the right side of your body. You may not be able to care for yourself or live alone. You are at greater risk of falling. You may develop muscle shortening or bedsores. Even with treatment, you may have lasting problems talking, thinking, or moving your body. Without treatment, your risk for another stroke increases. You may die from a stroke.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

IV:

You may need an IV to give you medicine, food, or liquids if you cannot swallow. Some IV lines can also be used to collect blood samples.

Tests:

  • CT or MRI scan: Healthcare providers use these pictures to see bleeding or blood flow blockage in your brain. You may be given dye to help the pictures show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast dye. Do not enter the MRI room with metal. Metal can cause serious injury. Tell the healthcare provider if you have a metal implant.

  • Blood tests: You may need routine blood tests while you are being treated for your stroke. If you are getting medicine to prevent blood clots, you may need extra tests. These tests can tell healthcare providers if you are getting the right amount of this medicine. If you are on a ventilator, you may need blood gas tests to check your oxygen level.

  • Arteriography: X-rays are taken of your arteries (blood vessels) to look for blood flow blockage.

  • Carotid ultrasound: This test uses sound waves to show the blood flow in your carotid arteries. The carotid arteries are blood vessels in your neck that carry blood to your brain. A carotid ultrasound checks for narrow or blocked carotid arteries.

  • Swallow study: X-rays are taken as you swallow certain foods and drinks. This test shows if food and liquids travel to your stomach correctly.

Monitoring:

  • Oxygen: Healthcare providers will monitor your oxygen levels. They will give you extra oxygen if your level drops too low. You may need a ventilator to give you oxygen if you cannot breathe on your own.

  • Neurologic exam: This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works after an injury or illness. Caregivers will check how your pupils (black dots in the center of each eye) react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.

  • Intake and output: Healthcare providers may need to know the amount of liquid you are getting and how much you are urinating. A Foley catheter is a tube placed in your bladder to drain your urine into a bag. Healthcare providers will remove the catheter as soon as possible, to prevent infection.

  • ICP monitor: A small tube is put through your skull and connected to a screen. Healthcare providers use the ICP monitor to keep an ongoing measurement of the pressure inside your skull.

Medicines:

  • Antipyretics: These decrease fever.

  • Thrombolytics: These break apart blood clots.

  • Anticoagulants and antiplatelets: These prevent blood clots from forming.

  • Other medicines: You may need medicine to treat diabetes, depression, high cholesterol, or blood pressure problems. You may need medicine to decrease the pressure in your brain, reduce pain, or prevent seizures.

Treatment:

  • Physical and occupational therapy: Physical and occupational therapists may exercise your arms, legs, and hands. They will help you be active as soon as possible after your stroke. Therapy may help you recover more quickly, and it may prevent muscle problems and bedsores. You may also learn new ways to do things such as dressing and bathing. This therapy decreases your risk of falling because you learn to move safely.

  • Bladder and bowel training: You may have trouble controlling your urine and bowel movements. A bladder training program can teach you ways to control when you urinate. A bowel program can help you learn how to plan for bowel movements. This training can help your skin stay clean and dry, and help prevent skin breakdown.

  • Swallow therapy: A therapist can help you learn safe ways to swallow to prevent coughing and choking.

  • Pressure stockings: These are long, tight stockings that put pressure on your legs to promote blood flow and prevent clots. You may need to wear pressure stockings before or after surgery or if you have poor circulation (blood flow).

  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

Feeding tubes:

You may need a feeding tube if you cannot swallow food or liquids well. The tubes may also be used to let air or fluids out of your stomach.

  • NG tube: An NG tube goes from your nose to your stomach.

  • G tube: A G tube goes from the outside of your body into your stomach. A PEG tube is a type of G tube.

  • J tube: A J tube is put through a small incision in your abdomen. The end of a J tube goes into your small intestine.

  • GJ tube: A GJ tube goes into both your stomach and small intestine.

Surgery:

  • Ventriculostomy: A tube is placed into your skull to drain extra fluid. This tube also checks the pressure in your brain.

  • Craniotomy: A healthcare provider removes blood from your brain or fixes a damaged blood vessel.

  • Carotid endarterectomy: This surgery widens the arteries so that blood can flow through more easily.

  • Blood vessel filter: You may need a filter placed in your blood vessel to prevent the complications a blood clot in your leg (DVT).

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Left Hemispheric Stroke (Inpatient Care)

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