What to Expect After a Stroke

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:

  Stroke Recovery: Coping With Eating Problems.

• 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. 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. For more information, see changes in perception after a stroke.
• Problems with vision. You may have problems seeing in some or all of the normal areas of vision. For more information, see vision problems 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.