Right Hemispheric Stroke

What is a right hemispheric stroke?

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


What causes a right hemispheric stroke?

  • Ischemic stroke: An artery to your brain gets blocked, usually by a blood clot. The clot stops blood and oxygen from reaching your brain.

  • Hemorrhagic stroke: A blood vessel breaks and leaks because a clot gets stuck in it, or the vessel wall is weak. Blood then flows out of the vessel and into brain tissue.

What are the signs and symptoms of a right hemispheric stroke?

  • Difficulty remembering, impulsive behavior, or mood changes

  • Paralysis on 1 or both sides of your body

  • Trouble walking, or falling toward your left side

  • Lack of awareness of the left side of your body

  • Trouble swallowing, speaking, reading, writing, or understanding language

  • Changes in mood or the ability to pay attention or solve problems

How is a right hemispheric stroke diagnosed?

Your caregiver will ask about your symptoms and when they started. He will ask about the medicines you take and if you drink alcohol or use street drugs. The following tests help your caregiver know where the stroke happened, and how much damage you have.

  • CT or MRI scan: Caregivers 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 caregiver 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 caregiver if you have a metal implant.

  • Arteriography: X-rays are taken of your arteries 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.

How is a right hemispheric stroke treated?

  • Medicines: The type of medicine you need depends on the type of stroke you had. You may need medicine to improve your blood's ability to clot and stop the bleeding. You may instead need medicine to break up blood clots, or to prevent them from forming. You may also need this type of medicine after bleeding is controlled, to prevent a clot from forming. You may also need medicine to lower a fever, treat diabetes or high cholesterol, or prevent seizures. Medicine may be given to keep your blood pressure at a certain level if it is too high or too low.

  • Rehabilitation: Rehabilitation (rehab) is an important part of treatment. Physical therapists help strengthen your arms, legs, and hands. You learn exercises to improve your balance and movement to decrease your risk of falling. Occupational therapists teach you new ways to do daily activities, such as getting dressed. A speech therapist helps you relearn or improve your ability to talk and swallow.

  • Ventilator: You may need to get oxygen through a ventilator if your stroke affects your ability to breathe. A tube is put into your airway through your nose, mouth, or an incision in your neck. The ventilator gives you oxygen through the tube.

  • Surgery: You may need to have a tube placed in your skull. The tube drains extra fluid and checks the pressure in your brain. You may also need surgery to widen arteries or to place a filter into a blood vessel. Surgery can improve blood flow and prevent blood clots.

What increases my risk of a right hemispheric stroke?

  • You are at least 55 years old.

  • You are a man.

  • You are African American.

  • You are a woman and use birth control pills, or you take hormone replacement medicine.

  • Your father or mother had a stroke, or you had a low birthweight.

  • You have high blood pressure, blood vessel disease, or sickle cell anemia that was not treated.

  • You have diabetes, atrial fibrillation, or another heart condition.

What can I do to decrease my risk of a stroke?

  • Manage health conditions: High blood pressure, diabetes, and high cholesterol can all increase your risk of stroke. Take your medicine as directed. Follow your caregiver's instructions to check your blood pressure and blood sugar levels. Write the numbers down to show him.



  • Eat healthy foods: Healthy foods can help prevent or manage high blood pressure, high cholesterol, and diabetes. Eat foods that are low in fat, cholesterol, salt, and sugar. Eat at least 5 servings of fruits and vegetables each day. Eat foods that are high in potassium, such as potatoes and bananas. If you take warfarin, it works best when you eat about the same amount of vitamin K each day. Vitamin K is found mainly in leafy green vegetables. Ask your caregiver for a list of other foods that contain vitamin K.

  • Reach or stay at a healthy weight: Weight loss can decrease your blood pressure and your risk of stroke. Ask your caregiver how much you should weigh and how to lose weight safely. Ask your caregiver how often you should exercise and which exercises to do. You will need to exercise carefully after a stroke so you do not fall.

  • Limit alcohol: Men should limit alcohol to 2 drinks per day. Women should limit alcohol to 1 drink per day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

  • Do not use street drugs or smoke cigarettes: Your risk of stroke increases if you use drugs such as cocaine, or you smoke cigarettes. Ask your caregiver for help if you are having trouble quitting.

How can I tell if someone is having a stroke?

Know the F.A.S.T. test to recognize the signs of a stroke:

  • F = Face: Ask the person to smile. Drooping on 1 side of the mouth or face is a sign of a stroke.

  • A = Arms: Ask the person to raise both arms. One arm that slowly comes back down or cannot be raised is a sign of a stroke.

  • S = Speech: Ask the person to repeat a simple sentence that you say first. Speech that is slurred or sounds strange is a sign of a stroke.

  • T = Time: Call 911 if you see any of these signs. This is an emergency.

When should I contact my caregiver?

Contact your caregiver if:

  • Your blood pressure is higher than you were told it should be.

  • You have skin tears, or sores on your heels, head, or buttocks from lying in bed.

  • You have bowel movement problems.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You have a seizure.

  • You are bleeding from your rectum or nose.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • You have chest pain that spreads to your arms, jaw, or back.

  • You suddenly feel dizzy, lightheaded, and have shortness of breath.

  • You may have chest pain when you take a deep breath or cough. You may cough up blood.

  • You have weakness or numbness in your arm, leg, or face.

  • You are confused and have problems speaking or understanding speech.

  • You have vision loss or a severe headache.

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. 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.

© 2013 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.

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