Effects of a Stroke Explained: The Potential Physical & Cognitive After Math

Strokes are medical emergencies that impact the supply of blood in the brain. With appropriate and timely medical treatment, the person’s life is often saved, but potential brain damage will likely cause secondary effects.

Every stroke is different and, as a result, every patient will experience secondary effects differently. This means it’s a good idea to understand the potential effects, so that you’re able to catch signs early.

This page has been updated to contain a long, comprehensive list of the most common effects of a stroke. Bookmark this page, and use the links below to jump straight to any section.

Table of contents

• What causes the effects of a stroke?
• Physical effects
• Cognitive effects
• Sensory effects
• Medical complications

What Causes the Effects of a Stroke?

A stroke is caused when the supply of blood in the brain is compromised, depriving local brain tissue of oxygen-rich blood. Once the stroke has been treated, normal blood flow is restored. This puts an end to the stroke, but the brain damage left behind can lead to secondary effects.

Two factors influence the possible effects: the size and location of the stroke.

The size of the stroke often correlates with the severity of the secondary effects. For example, patients that sustain mild strokes often experience very minimal effects that resolve quickly while massive stroke survivors may sustain severe, long-lasting effects, such as paralysis.

The area of the brain affected by stroke also influences the effects sustained. For example, a stroke in the left hemisphere is likely to lead to language issues because that’s where the language center of the brain usually resides.

Nothing is guaranteed, though. Every stroke is different and every brain is wired a bit differently. The good news is that, by understanding some of the most common secondary effects, you can prepare yourself for the road to recovery ahead.

Now that you understand why stroke side effects occur, let’s dig into the list of the most common ones.

Physical Effects of a Stroke

The most outwardly notable effects of a stroke are the ones that impact physical movement.

We need to be able to move to accomplish the activities of daily living such as eating, dressing, and toileting, as well as walking. Therefore, the physical effects of a stroke often get the most attention from occupational and physical therapists.

Here are some of the most common physical after effects of stroke:

Hemiparesis or hemiplegia

Many stroke survivors sustain motor impairments that affect one side of the body (the side opposite of where the stroke occurred). Hemiparesis describes weakness on one side of the body while hemiplegia describes paralysis on one side of the body. Treatment involves physical and occupational therapy to rewire the brain, restore movement, and explore compensatory techniques as needed. Speech therapy may also be needed to address speaking and eating challenges if one side of the face has been affected.

Learn more about hemiparesis and hemiplegia after stroke »

Spasticity

When affected muscles become stiff and tight, it’s due to a condition called spasticity. This can limit a stroke survivor’s range of motion. Treatment involves physical and occupational therapy to rewire the brain and stretch/loosen the muscles.

Learn more about spasticity »

Contractures

When spasticity is left unmanaged, it can progress into contractures, which are characterized by extreme stiffness. Contractures are caused by a shortening of the muscles or connective tissue that span one or more joints. Management involves splints or casts, passive and prolonged stretching exercises, or potentially surgery.

Learn more about contractures after stroke »

Post-Stroke Fatigue / Excessive Sleeping

Fatigue after a stroke is common as the brain is trying to heal itself, which may drain the patient’s energy. Everyday tasks may take more energy to complete, resulting in daytime sleepiness or fatigue. As a result, excessive sleeping is common in stroke survivors.

While excessive sleeping early on in recovery is encouraged and beneficial, if this continues later in recovery it may impede rehabilitation and be a sign of other underlying issues. Speak to your doctor if this is the case for you.

Learn more about fatigue after stroke »

Balance Issues

The motor impairments that follow stroke may result in poor balance, putting stroke survivors at risk of falling. Rehabilitation exercises, particularly for the legs, feet, and core, can help restore strength and movement in the body and improve balance. In the meantime, a physical therapist can recommend an appropriate assistive device for your safety, such as a cane or walker.

Learn more about improving balance after stroke »

Dysphagia (Difficulty Swallowing)

If you have difficulty swallowing after stroke, it could be a sign that you have a secondary effect known as dysphagia. Patients work with Speech Language Pathologists (SLPs) to retrain the brain to control the swallowing muscles. In some cases, a feeding tube may be required.

Learn more about dysphagia »

Shoulder Complications

Because the shoulder joint is particularly vulnerable to injury, many stroke survivors experience shoulder pain due to weakness on their affected side. If left untreated, it may develop into more serious conditions like shoulder subluxation (where the shoulder becomes partially dislocated) and frozen shoulder (where the surrounding ligaments then become inflamed).

Learn more about shoulder pain after stroke »

Foot Drop

Image source: Wikipedia anatomy of motion

When patients have difficulty with dorsiflexion (lifting the front part of the foot towards their shin), they are dealing with a condition called foot drop. Management involves wearing an AFO brace to prop the foot up and improve safety. Treatment involves rehabilitation exercise and physical therapy.

Learn more about foot drop after stroke »

Curled Toes

When the toes curl under, often in a painful manner, it’s the result of spasticity in the feet. This condition is known as curled toes. Treatment involves toe separators, AFOs, and of course, rehabilitation exercise.

Learn more about treating curled toes after stroke »

Learned Nonuse

If stroke survivors fail to move their muscles (either through active exercise or passive range of motion), they may develop a condition called learned nonuse. This condition causes your brain to have even more difficulty paying attention to the affected muscles, therefore making it harder to rehabilitate these muscles and over-relying on your non-affected side. This is where the phrase “use it or lose it!” comes from.

Learn how to prevent learned nonuse »

Physical and occupational therapy often focus on restoring physical abilities. However, the cognitive effects of stroke are also important to understand because they can impair the ability to perform the activities of daily living as well.

Cognitive Effects of a Stroke

Next you’ll discover the potential cognitive effects of a stroke. These are more likely to occur after a frontal lobe stroke or a stroke that impairs the brain’s ability to think analytically or rationally.

Here are the most common cognitive effects of a stroke:

Aphasia (Difficulty with Language)

Aphasia is a common language difficulty that can occur after a stroke, especially left hemisphere strokes. Not all language problems are considered aphasia, but it’s an umbrella term that encompasses the majority of speech issues. Treatment involves speech therapy exercises. If the patient cannot talk at all, singing therapy may help. Alternative forms of communication can also be introduced during speech therapy if needed.

Learn more about language problems after stroke »

Impaired Memory and Attention

The frontal lobe handles higher cognitive functions such as memory and attention. When it sustains damage after stroke, it can make it more difficult to execute everyday cognitive functions, like remembering where you put your keys or paying attention to someone talking.

Sometimes memory after stroke improves on its own (spontaneous recovery). Other times, studies have shown that cognitive training helps improve cognitive function after stroke. This type of training is typically done with a speech therapist.

See all cognitive training activities for stroke patients »

Vascular Dementia

Post-stroke dementia refers to vascular dementia which can stem from the impact of the stroke. Vascular dementia can cause cognitive issues like impaired thinking and reasoning, memory loss, confusion, decreased attention span, and more. It’s important to work with a medical team for diagnosis and treatment.

Learn more about post stroke dementia »

Pseudobulbar Affect

A post-stroke condition called pseudobulbar affect, or emotional lability, can cause random outbursts of laughter and/or crying when inappropriate to the context/situation. Treatment includes medication and/or psychotherapeutic intervention.

Learn more about pseudobulbar affect after stroke »

Behavior Changes

Some stroke survivors demonstrate different behaviors after a stroke, such as anger or aggression. Sometimes irregular behaviors may occur, which could be a secondary effect caused by vascular dementia or other cognitive changes.

Learn more about behavior changes after stroke »

Depression and Anxiety

Depression is one of the most common complications after a stroke, affecting almost half of survivors. Don’t hesitate to talk to your doctor about your mental health. Treatments can help survivors maintain the motivation necessary to keep pursuing rehabilitation.

Learn more about depression after stroke »

With cognitive effects of a stroke, it’s best to work with a Speech Language Pathologist. SLPs are highly skilled in working with stroke survivors with language difficulties and other cognitive issues.

Sensory Effects of a Stroke

The thalamus and parietal lobe are two areas of the brain that play large roles in processing and regulating sensory input. When sensory functions sustain damage following a stroke, it can cause sensory issues such as numbness or pain.

A stroke in the thalamus or parietal lobe is most likely to cause sensory issues; however, it’s not guaranteed. Any type of stroke can create various effects, because every stroke is different and every brain is wired differently.

This is why it’s helpful to understand all the possible effects of a stroke, so that you can catch early signs. Here are the most common sensory effects after stroke:

Numbness

Post-stroke numbness is a common secondary effect that causes a total loss of sensation in the affected area. Fortunately, spontaneous recovery is possible where the numbness goes away on its own. In many cases, sensory reeducation may be necessary to help stimulate the brain to improve sensation.

Learn more about numbness after stroke »

Tingling or Pins-and Needles Sensations

Another sensory-related effect of a stroke includes tingling and pins-and-needles sensations. As with numbness, sometimes spontaneous recovery is possible; otherwise, sensory reeducation may help. It’s also important to note that sometimes pins-and-needles sensations occur before the onset of central pain syndrome, which we discuss next.

Learn more about tingling sensations after stroke »

Hemineglect

Image from Journal of Neurology

Hemineglect is a spatial awareness problem that prevents the stroke survivor from noticing half of their environment and body — often the left side (informally known as left neglect). If someone with left neglect is asked to fill in the numbers on an empty clock, they may cram everything into the right side without realizing it, as shown in the image above.

Learn more about hemineglect »

Visual Disturbances

When a stroke affects the brain’s visual processing abilities, vision may be affected. Some patients develop double vision or sustain visual “field cuts” where half (or sometimes a quadrant) of the visual field is missing. Treatment includes vision training and/or specialized glasses.

Learn more about regaining vision after stroke »

Central Post-Stroke Pain Syndrome

Central pain syndrome is a chronic pain condition that can occur after a stroke, particularly a thalamic stroke. It often has a delayed onset, occurring months or even years after a stroke occurs. Usually, it starts with extreme sensitivity or pins-and-needles sensations, but progresses into chronic pain. There are ways to treat it, and your medical team should be consulted every step of the way.

Learn more about central pain syndrome treatment »

Post-Stroke Pain

Not all pain after stroke is chronic. Sometimes localized pain can occur after a stroke, usually stemming from other effects like spasticity or contractures. This type of pain is best treated by addressing the underlying conditions.

Learn more about post stroke pain »

Medical Complications After Stroke

Next you’ll learn about potential medical complications after stroke. Some are primary complications that are the direct result of a stroke while others are secondary complications caused by the effects of a stroke.

Here are some of the most common medical complications after stroke:

Bedsores

Bedsores are pressure ulcers that develop when there is prolonged pressure on areas of the body due to decreased mobility. They often happen during longer hospital stays, and they are unfortunately very common in stroke survivors. You can help prevent bedsores by re-positioning the body every couple hours.

Learn more about pressure ulcers »

Incontinence

Stroke can affect your ability to control your bladder and/or bowel movements, which is a condition known as incontinence. It can vary in severity, causing difficulties such as light leaking or complete loss of control.

Learn more about incontinence after stroke »

Seizures

About 5% of stroke survivors experience seizures after stroke. Seizures occur when there is sudden disorganized electrical activity in the brain, causing changes in movement (e.g. convulsions), behaviors, and levels of awareness or sensation. If seizures occur more than once, the person may be diagnosed with epilepsy. Common treatment includes anticonvulsant medication or a vagus nerve stimulator.

Learn more about seizures after stroke »

Pneumonia

Sometimes stroke survivors with dysphagia (impaired swallowing) accidentally inhale food into the lungs. These occurrences are called aspirations, which can lead to pneumonia in stroke survivors. Aspirations should be taken very seriously because they are the biggest cause of attributable mortality from medical complications after stroke.

Learn more about pneumonia after stroke »

Deep Vein Thrombosis

Deep vein thrombosis is a medical condition where blood clots form in veins of the legs, often due to impaired mobility. Since many stroke survivors struggle with mobility issues, this stroke risk factor increases during recovery. If you’re at risk of developing deep vein thrombosis, doctors may prescribe blood-thinning medication.

Learn more about DVT after stroke »

Headaches

Headaches following a stroke are a common and worrisome event. If you experience severe or mild headaches that last for longer than a few hours, seek medical attention immediately because it may signify further medical complications.

Learn more about headaches after stroke »

Seek medical attention if you noticed any of these effects or complications in your loved one after a stroke. A medical evaluation is the best way to determine if new effects require further treatment.

You’re already a step ahead by educating yourself about all the possible effects of a stroke. If you’d like to keep learning more, you can download more stroke recovery tips in our free ebook below: