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Bilateral Stroke: Understanding Stroke on Both Sides of the Brain

neurologist holding brain scan and pointing to bilateral stroke signs

Unlike typical strokes, which generally affect one hemisphere, a bilateral stroke affects both sides of the brain.

When more brain tissue is affected, there are greater chances of sustaining severe post-stroke side effects. Fortunately, the rehabilitation process helps stroke survivors recover.

To help you recover from bilateral stroke, this article will explain the causes and symptoms of bilateral stroke and how it differs from typical strokes. Then we will dig into the rehabilitation process.

What Causes Stroke on Both Sides of the Brain?

When a stroke occurs, the supply of blood in the brain becomes compromised by either a clogged or burst artery. This is a life-threatening medical event, as brain cells require oxygen-rich blood in order to function.

Before doctors proceed with treatment, they must know the type of stroke that is occurring.

The first type, which is more common, is called an ischemic stroke, which occurs when a blood clot clogs an artery in the brain, cutting off the supply of blood. The second type, which is less common, is called a hemorrhagic stroke, which occurs when an artery in the brain bursts.

illustration of bilateral stroke

Most often, a stroke is a localized event that impacts one of the brain’s two hemispheres.

Each hemisphere in the brain controls movement on the opposite side of the body. For instance, a stroke in the left hemisphere may result in poor movement on the right side of the body.

However, when movement on both sides of the body is affected, it’s usually caused by multiple strokes on both sides of the brain — a bilateral stroke.

Unfortunately, diagnosis can be difficult because the typical stroke symptoms may display differently. For example, instead of weakness on one side of the body (a well-known symptom of stroke) both sides of the body may be affected, making the cause of this condition less clear.

Furthermore, a bilateral stroke might not be the result of multiple strokes. Generally, each hemisphere in the brain is separate and attaches through the corpus callosum. However, in rare cases, the frontal lobe may share blood supply between both hemispheres. When a stroke occurs in this shared area, it can result in a bilateral stroke. But again, this is rare.

As with all strokes, timely treatment is necessary to restore blood flow in the brain and save the person’s life.

How Is a Bilateral Stroke Treated?

Treatment for bilateral stroke occurs in two phases: stopping the strokes, and rehabilitating the brain.

Stopping the Stroke

When ischemic stroke is involved (the type caused by a blood clot), doctors can often resolve it with clot-busting drugs like aspirin or tPA. When drugs are not sufficient (especially if too much time has passed since the onset of the stroke), doctors may use surgery to remove the clot in the brain.

Hemorrhagic stroke (the type caused by a burst artery) is usually treated through surgery to repair the ruptured artery and relieve swelling in the brain.

It’s important to know that hemorrhagic stroke is not treated with clot-busting drugs, because it would only make the bleeding in the brain worse. For this reason, no one should self-administer aspirin for stroke symptoms. While aspirin may help ischemic stroke, it would only worsen the bleeding during a hemorrhagic stroke. This is why doctors must diagnose the type of stroke before swiftly beginning treatment.

Rehabilitating the Brain

Once the stroke has been treated and blood flow is restored in the brain, there is good news and bad news. The bad news is that brain damage is irreversible and the brain cells that died during the stroke cannot come back. The good news is that the brain is resilient and possesses the ability to rewire itself and bounce back from injury. This process is called neuroplasticity.

Neuroplasticity allows new areas of the brain to take on lost function. For instance, if speech has become impaired after a bilateral stroke, new areas of the brain can take on the function of speech. However, the process requires hard work from the survivor to occur, which is emphasized during rehabilitation.

What Side Effects Can Occur After Bilateral Stroke?

At the beginning of rehabilitation, your medical team will work to diagnose any post-stroke side effects that have occurred.

Your neurologist is a great resource for learning more about the potential side effects of your stroke. They can provide information about which areas of the brain were affected by stroke. This has strong implications for the after math that follows, because each area of the brain controls different functions.

For instance, if the left hemisphere was affected, it’s possible that the person may struggle with language difficulties. This is because the language center of the brain resides predominantly in the left hemisphere.

Because a bilateral stroke affects both sides of the brain, there is a wide diversity of side effects that may occur, such as:

  • Language difficulties like aphasia or apraxia of speech
  • Movement difficulties on both sides of the body, such as weakness or paralysis
  • Cognitive impairments such as poor memory or difficulty with problem solving
  • Dysphagia (difficulty swallowing)
  • Sensory issues such as numbness, tingling, or post-stroke pain

The side effects that occur after a bilateral stroke vary greatly between survivors. Every brain is wired differently, and every stroke is different. This means there are an endless number of ways that a brain can be affected by a stroke.

For this reason, you must work closely with your medical team to diagnose your post-stroke side effects and create a rehabilitation plan to follow.

The Rehabilitation Process

Rehabilitation focuses on restoring the survivor’s abilities that were compromised by the stroke. For instance, if speech was impaired by the stroke, rehabilitation focuses on improving the survivor’s ability to communicate.

Fortunately, neuroplasticity makes recovery possible. It requires consistent effort on the survivor’s part, as the brain relies on experience in order to rewire itself. In other words, when a stroke survivor experiences something on a regular basis, that is what the brain will respond to.

For instance, when speech therapy exercises are practiced on a regular basis, the brain responds by strengthening the pathways that control speech. This continued experience is how rehabilitation works after a bilateral stroke, or any other type of stroke.

Here are some of the methods that might be used during rehabilitation:

  • Physical therapy. After bilateral stroke, mobility on both sides of the body often becomes impaired. Rigorous physical therapy and stroke rehabilitation exercise can help improve this side effect.
  • Passive exercise. If a bilateral stroke results in post-stroke paralysis, then passive exercise can help improve mobility and encourage blood flow in the affected limbs. This can be accomplished by having a caregiver assist your body parts with various movements.
  • Speech therapy. Survivors can work with experts called Speech Language Pathologists to regain communication, cognitive, and swallowing skills.
  • Occupational therapy. Sometimes a severe stroke can impact a person’s ability to lead an independent life. Occupational therapists are trained in helping survivors regain independence with the activities of daily living.

These are the most common rehabilitation methods used for recovery from bilateral stroke. However, it’s not a complete list. Instead, work with your therapists to create a rehabilitation plan that targets your unique needs and goals.

Hope for Recovery from Bilateral Stroke

Bilateral stroke is a rare event that can occur from multiple strokes on both sides of the brain or a unique instance where a stroke in one hemisphere affects the other.

Fortunately, there is hope for recovery. By participating in rigorous therapy, you can rehabilitate your body and mind, and help minimize other side effects that may have occurred.

Work closely with your doctors and therapists to come up with a treatment plan that’s suited to your unique needs. Best of luck on the road to recovery.

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