Initial disabilities

Your disabilities and your ability to get better after a stroke depend on:

• Which side of the brain was affected (whether it is your dominant side).
• Which part of the brain was damaged by the stroke.
• How much of the brain was damaged.
• Your general health before the stroke.

Impairments after a stroke may include problems with muscles and movement. These include:

• Weakness on one side of the body. This may cause you to have trouble walking, grasping objects, or doing other tasks. The side of the body that is affected is opposite from the side of the brain that was damaged by the stroke.
• Joint pain and rigidity. A person with a very weak arm may have shoulder pain caused by a tight or locked-up joint. Movement of the joint is essential to keep it from "freezing" and to make sure that you can move it easily when your strength returns.
• Muscle stiffness or spasms (spasticity). You may need certain medicines or injections of substances that block nerve reactions. For more information, see treatment for stroke-related spasticity.
• Problems with your sense of touch or your ability to feel hot and cold. You may also have problems judging the position of parts of your body.
• Pain, numbness, or tingling in your limbs.
• Trouble with walking and coordinating body movements.
• Problems swallowing and eating (dysphagia). For more information, see dysphagia. See also:

  Managing eating problems after a stroke.

• Urinary or bowel problems. You may have trouble holding your urine (urinary incontinence) or trouble emptying your bladder (urinary retention). Or you may have constipation or problems controlling bowel movements. Although this can make you feel embarrassed or discouraged, these issues are usually not permanent. For more information, see how to manage bladder and bowel problems after a stroke.

Other problems involve how you process information and your emotions. These include:

• Speech and language problems (aphasia). Aphasia usually results from damage to the left side of the brain, which is the area responsible for language. Some people who have aphasia may not be able to understand written or spoken language, read or write, or express their own thoughts. For information on coping with communication problems, see how to manage speech and language problems after a stroke.
• Memory and cognitive problems. You may have damage to parts of your brain that control awareness, learning, and memory. You may have trouble focusing or remembering. It may be difficult to make plans, learn new activities, or do other complex tasks. You may not be able to acknowledge the physical impairments caused by your stroke. For more information, see memory problems, changes in speed of action, and changes in judgment after a stroke.
• Problems with perception. You may have trouble judging distance, size, position, rate of movement, form, and how parts relate to the whole. For more information, see changes in perception after a stroke.
• Problems recognizing your affected side. After a stroke, some people have problems seeing to one side. For example, people with right-sided paralysis may have trouble seeing to the right. Most people learn to adjust by turning their head toward their affected side. If you do not turn your head to the affected side, you may forget or ignore that side of your body. Some people have trouble recognizing body parts on the affected side. This is especially true for people who do not have feeling in the affected arm or leg.
  • You may recognize objects on the unaffected side of your body but not on the affected side. Some people may see objects and not be able to attach a meaning to them. For example, you may examine a fork curiously without remembering how to use it for eating.
  • Objects may look closer or farther away than they really are. You may notice this more when you are eating or dressing, or you may bump into furniture.
  For more information, see problems from neglecting the affected side of the body after a stroke.
• Emotional problems. Fear, anxiety, anger, sadness, frustration, and grief are common after a stroke. About one-third of people older than 65 who have had a stroke have symptoms of depression.¹ Depression is a serious condition that requires treatment. For more information, see changes in emotions and recognizing and dealing with depression after a stroke.