Common problems

There are several problems or disabilities stroke survivors may face in the first few weeks after having a stroke. Most of these will improve over time as the brain recovers. In severe cases, they may cause long-term disability.

Weakness or paralysis
Weakness, clumsiness or paralysis (hemiplegia) is one of the most recognisable and most common symptoms of a stroke. It usually happens on one side of the body. Weakness or paralysis of an arm or leg is often made worse by stiffness (spasticity) of the muscles and joints.

Balance
Unsteadiness (loss of balance) can be caused by damage to the part of the brain that controls balance. Or it may happen because of paralysis resulting in muscle weakness.

Swallowing
About 50 per cent of people have difficulty with swallowing after a stroke (dysphagia). This can be dangerous if food ‘goes down the wrong way’ and gets into the windpipe.

All stroke patients have a swallow test in hospital and are only allowed to drink and eat when it is shown they can swallow. Some people may need fluid thickeners and help with eating for a while.

Sleep and tiredness
Most people suffer from extreme tiredness (fatigue) in the first few weeks after a stroke. Many also have difficulty sleeping, which makes them even more tired.

Speech and language
Many people experience problems with speaking and understanding, and with reading and writing. This difficulty with language is called dysphasia (also known as aphasia)

When a person finds it hard to understand what is being said, it is called receptive dysphasia. Sometimes a person may understand what is being said but can’t find the right words to express what they want to say - this is called expressive dysphasia. People often have a mixture of both types of dysphasia.

Dysphasia is most common with strokes that damage the left side of the brain. The exception is in some left-handed people whose language area is on the right side of their brain.

Eyesight
A stroke can damage the parts of the brain that receive, process and interpret information that the eyes send. Sometimes, people who have had a stroke may have double vision or lose half of their field of vision - they can see everything over to one side but are blind on the other.

This can cause clumsiness and seemingly odd behaviour (like not eating food on one side of a plate). 

Perception and interpreting
People may have difficulty recognising familiar objects or knowing how to use them. They may also have problems with skills like telling the time if the brain can’t interpret what the eyes see.

Mental processes
A stroke often causes problems with mental processes such as thinking, learning, concentrating, remembering, making decisions, reasoning and planning. People may lose short-term memory, which makes it difficult to pay attention and concentrate.

Bladder and bowels
Difficulty controlling the bladder and bowels (incontinence) is not unusual after a stroke. Most people regain control in a few weeks.

Mood swings
Emotional ups and downs are very likely after a stroke. Depression, sadness, anger, anxiety, low self-esteem and loss of confidence are common. Sometimes people find it hard to control their emotions and may cry, swear or laugh at inappropriate times. They may find that their inhibitions are lifted and their behaviour seems out of character.

Sensation
Some people have problems with sensation - they feel too much or too little. They may be very sensitive to colour, sound and light. Or they may not feel painful sensations like heat or sharp objects, which can cause accidents and injuries.

Pain
Pain can be caused by the stroke (for example, shoulder pain and spasticity), or may be caused by problems the person had before the stroke being made worse.

Recovering from a stroke takes time
After an initial spurt of recovery in the first few weeks, the mending process is very gradual. It may take more than a year before the person has made the best possible recovery, and some people continue to improve over a much longer period.

Links
Audio version - Common problems (708 kb)
Brain attack
Types of stroke
Common symptoms
Transient Ischaemic Attack
Stroke can happen to anyone
Damage to the brain

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