A stroke can cause physical, mental, and emotional symptoms. The specific symptoms can depend on the location of the stroke, how much damage it causes to surrounding brain tissue, and how soon treatment begins.

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A stroke is like your brain’s version of a heart attack. It happens when a clot blocks or decreases blood flow to part of your brain. It can also happen when a vessel ruptures and leaks blood onto brain tissue. Either way, nearby brain cells can’t get the oxygen they need, which can cause them to die.

All strokes are life threatening medical emergencies, but there’s a lot of variation in how you might experience a stroke. Symptoms can depend on the location of the stroke and the extent of damage to surrounding brain tissue.

This article looks at the physical, mental, and emotional effects of a stroke and why immediate medical intervention matters.

A stroke can cause physical, cognitive (mental), and emotional symptoms in both the short and the long term.

Physical symptoms of a stroke may include:

  • weakness, numbness, or paralysis on one side of your body
  • problems with balance and coordination
  • vision problems or vision loss
  • sudden headache
  • trouble swallowing

Mental symptoms may include:

  • trouble speaking, reading, writing, or understanding others
  • memory and concentration issues
  • problems with executive functions such as planning, problem-solving, and reasoning
  • difficulty performing skilled physical activities such as dressing yourself
  • impaired spatial awareness, such as difficulty understanding how to use objects or recognizing your own body

Stroke can also lead to changes in behavior and emotional symptoms such as:

  • crying
  • feelings of hopelessness, frustration, and anger
  • social withdrawal
  • low mood or mood changes
  • anxiety

How location affects symptoms

Your brain is a complex organ, with specific areas controlling certain functions. In broad terms, a stroke on the right side of your brain may be more likely to cause:

  • paralysis on the left side of your body
  • aimless, confused movements
  • problems with spatial orientation

And a stroke on the left side of your brain may be more likely to cause:

  • paralysis on the right side of your body
  • speech and language problems
  • slow, cautious behaviors

The exact location of the stroke can also cause specific types of symptoms.

Your brain stem regulates consciousness, blood pressure, and breathing. A brain stem stroke can affect all these systems, and symptoms can occur on both sides of your body.

A severe brain stem stroke can lead to locked-in syndrome, a condition in which you’re conscious but cannot move or speak.

Your cerebellum sits just above your brain stem. A cerebellar stroke can cause symptoms such as:

  • nausea and vomiting
  • headache
  • dizziness
  • lack of coordination
  • abnormal reflexes
  • uncontrollable eye movements
  • difficulty speaking or slurred speech

Stroke recovery is different for each person. It has a lot to do with the severity of the injury to your brain and how quickly treatment starts. Some people recover quickly, while others may need long-term rehabilitation.

Stroke is a leading cause of acquired permanent disability. According to the American Stroke Association, 10% of people who have a stroke need care in a long-term care facility and 40% have moderate to severe impairments.

People often experience some spontaneous but incomplete recovery. Research suggests that the most significant improvements happen in the first weeks after a stroke, with a plateau after 3 months. By 6 months, spontaneous recovery is typically at its limit.

Some symptoms may not appear until later

Though many stroke symptoms are obvious and immediate, some may not develop for months or years after a stroke.

For example, many people have sleep problems and fatigue in the first few weeks after a stroke. And about one-third of stroke survivors develop depression at some point. Depression isn’t related to the specific stroke site or type of stroke, but it’s more common in people who have problems with language expression and comprehension.

The role of rehabilitation

Within hours of a stroke, your brain starts working on forming new synapses (connections). That’s why rehabilitation usually starts within a day or two of a stroke.

Some researchers have found that, with the right interventions, people can continue to improve well beyond 6 months. Depending on your symptoms, these interventions may include:

Stroke is a life threatening emergency in which every second counts. Remember the acronym “FAST” to help identify the warning signs:

  • F = Face: Ask the person to smile — does one side droop?
  • A = Arm: Ask the person to raise both arms — does one arm drift downward?
  • S = Speech: Is the person’s speech slurred?
  • T = Time: If the answer to any of these questions is “yes,” it’s time to call 911.

Other stroke symptoms may include:

  • confusion or disorientation
  • vision changes or sudden loss of vision in one or both eyes
  • dizziness, loss of balance, or lack of coordination
  • severe headache

When you call 911, medical staff can start treatment on the way to the emergency room and alert the hospital that you’re on the way. Quick treatment can help restore blood circulation so fewer brain cells are damaged.

Treatment is most effective when started within 1 hour of the first symptoms. Those who get to an emergency room within 3 hours tend to have less disability after 3 months than those whose care is delayed.

A stroke has many potential symptoms, depending on where in your brain it occurs, how much damage it causes, and how soon treatment begins. Recovery is different for each person and may take anywhere from a few weeks to years.

Stroke is a life threatening emergency. Every second counts. The sooner you can start treatment, the better your chance of a good recovery will be.