Left Side vs. Right Side Strokes: What are the Differences?

The human brain is a highly complex organ responsible for much more than an individual’s thoughts, imagination, and personality. It controls everything, including the senses, speech, movement, body temperature, and heart rate. The brain is divided into two sides — the right and the left hemispheres — each with multiple folds and lobes, which are responsible for unique abilities.

When a stroke occurs, its symptoms and effects can vary depending on whether the stroke happens in the left or right hemisphere of the brain. The location in the brain where a stroke occurs also affects treatment, making it important to understand the differences.

How left-side and right-side strokes differ

The terms right-brain stroke and left-brain stroke refer to the side of the brain affected by the stroke. Both hemispheres control vital functions and a stroke in either can be debilitating or fatal. Most people survive their first stroke with prompt medical care. Symptoms can vary depending on the patient’s dominant hemisphere, which is often associated with handedness.

Generally, left-brain strokes occur more often but are not necessarily easier to recognize than right-brain strokes. For most right-handed people, the dominant hemisphere is the left. For left-handed people, the dominant hemisphere is usually the right.

Symptoms affecting the left side of the body usually indicate a right-brain stroke since the right hemisphere controls the opposite side. Each hemisphere has distinct functions. The right controls movement on the left side, spatial awareness, appreciation of music and art, imagination, intuition, insight and holistic thinking. In right-handed individuals, language is typically processed in the left hemisphere, but among left-handed people, it may occur in either hemisphere.

The left hemisphere is responsible for logical thinking and reasoning — such as math, science, and other number skills — and controls movements on the right side of the body. This distinction explains why the results and disabilities of a stroke depend on which hemisphere is affected.

Left hemisphere stroke symptoms & effects

Left-brain stroke symptoms include:

• Right-sided weakness or paralysis
• Possible speaking and language difficulties (may not always occur)
• Visual impairment
• Swallowing challenges/facial weakness
• Slow, cautious behavior
• Varying levels of cognitive impairments

Common effects of a left hemisphere stroke include:

• Hemiplegia/hemiparesis: A left-brain stroke often results in impaired strength on the body’s right side.
• Aphasia: Left-hemisphere stroke survivors may experience language impairment and difficulties.
• Apraxia of speech: Apraxia is a condition that makes it difficult to engage the muscles in and around one’s mouth that helps form recognizable speech.
• Dysphagia: Left-sided stroke survivors may also have trouble swallowing
• Cognitive impairments: A left-hemisphere stroke may specifically cause deficits in memory or problem-solving ability. It may also impair verbal working memory (VWM), leading to difficulties with short-term memory or processing new verbal information immediately.
• Visual loss: Loss of vision on one side, particularly in the right visual field (homonymous hemianopia).

Right hemisphere stroke symptoms & effects

When the opposite side of the brain suffers a stroke, the symptoms may be slightly different. Here are some possible symptoms of a stroke in the right side or the brain:

• Sudden outbursts of emotion
• Memory loss
• Facial weakness
• Poor decision-making
• Possible paralysis on the body’s left side
• Quick, overly curious behavior

Common effects of a right-side stroke

• Hemiplegia/hemiparesis: Right-brain stroke causes weakness or paralysis on the body’s left side
• Prosopagnosia: This condition describes a difficulty in recognizing faces.
• Left neglect: Right-brain stroke survivors can experience an unawareness of the left side of their environment.
• Homonymous Hemianopia: A stroke sufferer only sees one-half of their expected field of vision in each eye simultaneously.
• Anosognosia: Damage to the parietal lobe in the brain’s right hemisphere could result in neglect or denial of disability.
• Pseudobulbar effect: Sudden, uncontrollable outbursts of laughing or crying.

Side-by-side breakdown of left-side and right-side stroke effects

Stroke response treatment and long-term recovery

Immediate treatments for stroke symptoms might include fluid management, the use of blood thinners or medication to regulate blood pressure.

Long-term treatment for stroke recovery involves physical rehabilitation after the acute stage of the stroke — the “attack” on the left or right hemisphere — has passed. Recovery modalities may include physical therapy, cognitive therapy, speech and swallow therapy, occupational therapy, or other specialized protocols to maximize movement, independence and self-care.

Types of stroke rehabilitation specialists

Stroke rehabilitation is often a team effort, requiring a number of health care professionals working in various specialized fields to develop a multifaceted approach to recovery. The medical professionals working together to rehabilitate a stroke victim, include:

• Physiatrists: These are medical doctors specializing in physical medicine and rehabilitation, a specialty dedicated to improving function, pain, and quality of life in individuals with disabling conditions.
• Physical therapists: They help stroke patients regain strength and mobility. Physical therapists help patients learn how to move using canes,  walkers or wheelchairs as they move through their rehabilitation.
• Occupational therapists: They work with patients to improve their independence with self-care skills, like bathing and dressing.  They often work to improve readiness to return to school or work.  They also often make recommendations to make one’s home, work, or school environment more accessible and safe for them.
• Speech-language pathologists: These specialists assist stroke survivors and their family members in dealing with speech, language, and cognitive impairments.  They also help evaluate and treat swallowing and voice disorders.
• Neuropsychologists: These specialists are dedicated to understanding the relationships between the brain and behavior. They assess cognitive, emotional and behavioral functioning and provide treatment guidance based off strengths and weaknesses of cognitive changes in the patient after stroke.

Why rehabilitation is important after stroke

The rehabilitation process must start as soon as possible for stroke survivors to begin noticing positive changes. Despite the severity of a stroke’s effects, the brain has impressive neuroplasticity, which is the ability to adapt to changes. Repetition of targeted rehabilitation exercises sparks neuroplasticity, and the brain begins a self-healing “rewiring” process.

Rehabilitation teams led by physiatrists, help stroke survivors maximize their functional independence and achieve their individualized goals.

Leading expert in stroke treatment, recovery and rehab

Care from experienced and dedicated stroke rehab specialists can make a huge impact on the recovery of stroke survivors. Brooks Rehabilitation is a Florida-based rehabilitation center and system of care staffed by skilled and expert specialists in the rehabilitation of stroke and many other disabling conditions.

Contact Brooks Rehabilitation today for more information on our stroke rehabilitation and recovery services.