Effects of a stroke

Cognition (effects that are not apparent) after a stroke

The physical limitations are often immediately noticeable for most people around you. But the “invisible” effects are often less noticeable and often only reveal themselves later.

• Fatigue

  Many people suffer from fatigue after a stroke, which may be severe. This usually occurs frequently and over a long period of time. It is not always clear where this fatigue comes from. Researchers think that fatigue is a direct result of the damage to the brain itself, but that it can also have to do with physical and mental exertion. Things that used to be easy now require an enormous amount of effort and energy. Fatigue affects your physical, emotional, and mental function.

• Memory

  In general, people who have suffered a stroke are able to remember the things they used to do, but they are not able to remember new information, or have difficulty in doing so. Fatigue and reduced attention and concentration can play an important role in this. If this affects you, it also has a negative impact on your memory.

• Attention and concentration problems

  Problems with attention and concentration often occur after a stroke and can diminish or even disappear over time. Attention and concentration problems manifest themselves in different ways. It may be difficult for someone to concentrate on, for example, following a conversation, reading a book, or watching a movie. Someone may be distracted more quickly by all kinds of stimuli in the environment, such as a radio or conversations from other people.
  This often makes it difficult to do several things at the same time, such as driving and having a conversation with the passenger or cooking and talking.
   
  Many people experience that their ability to think quickly is reduced and that the information in the environment happens to quickly. After a stroke, it may take much more effort to follow a conversation or TV program. Activities that include many people, such as a birthday, are therefore experienced as difficult by many people. They have the feeling that the information is coming at them too quickly to be able to follow and process it. This is called slowed processing of information or slowed thinking. This can also manifest itself in activities that require rapid responses, such as traffic, sports, or certain high-speed activities at work.

• Reduced flexibility

  A number of people are no longer as flexible as they were before the stroke. This manifests itself, for example, in difficulty finding another solution to a problem when they get stuck. They may also have trouble changing plans if something does not work out the way they had expected.

• Observation

  Everyone recognizes errors that we sometimes have with spatial perception: for example, we estimate the distance incorrectly, so that we place the cup right next to the table instead of on it. You may think there is going to be another step down the stairs yet you have already reached the floor. This type of situation regularly happens to a patient who has had a stroke and has damage to the right hemisphere. They confuse left and right or are unable to assess the distance to a particular object. This can have consequences for activities that require a good spatial assessment, such as getting dressed. 

  Spatial neglect

  In the event of spatial neglect, people have difficulty responding to information in the environment. Often there is reduced attention or perception on one side: left or right. This may involve unconsciously “ignoring” the affected side. For example, people, objects, or events that are on your left (after damage to the right hemisphere) or your right (after damage to the left hemisphere).
   
  Not only sight, but also the hearing or awareness of your body can be reduced by neglect. Neglect is not caused by direct problems with the senses such as the eyes, by loss of field of vision, or by motor skill problems, but by a hiccup in the brain when making sensory information available.
   
  Shortly after a stroke, neglect occurs just as often after damage to the left and right hemispheres. In the chronic phase, it occurs mainly in the case of damage to the right hemisphere (with symptoms of loss of functions on the left side).

• Planning and organization

  As a result of a stroke, some people are no longer able to plan and organize life properly. This can have consequences for the organization of the day, household, and work. The result can be that someone loses track of the execution of complex actions, such as preparing a meal. Also, it is not always possible to plan in advance which things are needed for the activity. This manifests itself, for example, by going to the bathroom without taking the items needed to shower.

Changes in emotion and behavior