Basal Ganglia Stroke: Symptoms, Recovery, and More

Medically reviewed by Debra Sullivan, PhD, MSN, RN, CNE, COI on July 5, 2016Written by James Roland on July 5, 2016

Overview

Your brain has many parts that work together to control:

  • thoughts
  • actions
  • responses
  • everything that happens in your body

The basal ganglia in your brain are key to movement, perception, and judgment. The basal ganglia are neurons deep in the brain. Neurons are brain cells that act as messengers by sending signals throughout the nervous system.

Any injury to the basal ganglia can have serous, potentially long-term, effects on your movement, perception, or judgment. A stroke that disrupts blood flow to your basal ganglia could cause problems with:

  • muscle control
  • vision
  • swallowing
  • your sense of touch

You could even experience personality changes.

Symptoms

The symptoms of a stroke in the basal ganglia will be similar to symptoms of a stroke elsewhere in the brain. A stroke is the disruption of blood flow to a part of the brain, either because an artery is blocked or because a blood vessel ruptures, causing blood to spill into nearby brain tissue.

The typical stroke symptoms can include:

  • a sudden and intense headache
  • numbness or weakness on one side of the face or body
  • a lack of coordination or balance
  • difficulty speaking or understanding words spoken to you
  • difficulty seeing out of one or both eyes

Because of the unique nature of the basal ganglia, the symptoms of a basal ganglia stroke may also include:

  • rigid or weak muscles that limit movement
  • a loss of symmetry in your smile
  • difficulty swallowing
  • tremors

Depending on which side of the basal ganglia stroke affects, a variety of other symptoms could emerge. For example, if the stroke occurs on the right side of your basal ganglia, you may have difficulty turning to the left. You may not even be aware of things happening immediately to your left. A stroke on the right side of your basal ganglia may lead to severe apathy and confusion.

Causes

About 13 percent of all strokes are hemorrhagic strokes. Many of the strokes that occur in the basal ganglia are hemorrhagic strokes. That’s because the blood vessels in the basal ganglia are especially small and vulnerable to tearing or rupture.

A hemorrhagic stroke occurs when an artery in part of the brain ruptures. This can happen if the wall of an artery becomes so weak it tears and allows blood to leak out.

An ischemic stroke can also affect the basal ganglia. An ischemic stroke is a stroke that occurs when a blood clot or narrowed arteries prevent sufficient blood flow through the blood vessels. This starves tissue of the oxygen and nutrients carried in the bloodstream. An ischemic stroke can affect the basal ganglia if the middle cerebral artery, a major blood vessel in the middle of the brain, has a clot.

Risk factors

Risk factors for hemorrhagic stroke in the basal ganglia include:

  • smoking
  • diabetes
  • high blood pressure

These same risk factors can also increase your risk of an ischemic stroke.

Diagnosis

When you’re at the hospital, your doctor will want to know your symptoms and when they started, as well as your medical history. Some questions they may ask include:

  • Are you a smoker?
  • Do you have diabetes?
  • Are you being treated for high blood pressure?

Your doctor will also want images of your brain to see what’s going on. A CT and MRI scan can provide them with detailed images of your brain and its blood vessels.

Once emergency personnel know what type of stroke you’re having, they can give you the right type of treatment.

Treatment

One of the most important aspects of stroke treatment is time. The sooner you get to a hospital, preferably a stroke center, the more likely your doctor can minimize the damage from the stroke. That means don’t hesitate to call your local emergency services or have someone close to you call once symptoms begin.

If you’re having an ischemic stroke and you get to the hospital within a few hours of the start of symptoms, you may receive a clot-busting drug called tissue plasminogen activator (tPA). This can help dissolve most clots. If you’re having a hemorrhagic stroke, you cannot take tPA. This is because it inhibits clotting and boosts blood flow. The drug could cause a dangerous bleeding episode and potentially more brain damage.

Learn more: Stroke drugs »

For a hemorrhagic stroke, your doctor can fit a tiny clip onto the opened artery. You may also need surgery if the rupture is significant.

Recovery

If you’ve had a stroke, you should participate in stroke rehabilitation. If your balance was affected by the stroke, rehab specialists can help you learn to walk again. Speech therapists can help you if your ability to speak was harmed. Through rehab, you’ll also learn exercises and drills you can do at home to further your recovery.

In the case of basal ganglia stroke, recovery can be especially complicated. A right-sided stroke can make it difficult to perceive sensations on your left side even after the stroke is over. You may have difficulty knowing where your left hand or foot is in space. Making simple movements may become more difficult.

In addition to visual difficulties and other physical problems, you may also have emotional challenges. You could become more emotional than you were before the basal ganglia stroke. You may become depressed or anxious, and you may need the services of a mental health professional.

Outlook

Your long- and short-term outlook after a basal ganglia stroke depends on how quickly you were treated and how many neurons were lost. The brain can sometimes recover from injury, but it will take time to recover. Be patient, and know that you may not have a full recovery.

A basal ganglia stroke could have lasting effects that will interfere with your quality of life. Having any type of stroke increases your risk of having another stroke. Having a basal ganglia stroke or other damage to that part of the brain may also increase your risk of developing Parkinson's disease.

If you stick with your rehabilitation program and take advantage of services in your community, you may be able to improve your chances for recovery.

FAST assessment

Acting quickly is the key to stroke response, so it’s important to recognize some of the more obvious stroke symptoms.

The American Stroke Association suggests remembering the acronym “FAST.” It stands for:

  • Face drooping: Is one side of your face numb and unresponsive to your efforts to smile?
  • Arm weakness: Can you raise both arms high in the air, or does one arm drift downward?
  • Speech difficulty: Can you speak clearly and understand words that someone says to you?
  • Time to call your local emergency services: If you or someone near you is having these or other stroke symptoms, call 911 or your local emergency services immediately.

Don’t try to drive yourself to the hospital if you suspect you’re having a stroke. Call for an ambulance. Let paramedics evaluate your symptoms and provide initial care.

CMS Id: 106559