Researchers in Germany find that strokes affecting the right side of the brain may be under-diagnosed compared with to those affecting the left side, because of differences in symptoms. Consequently, someone who suffers a stroke that damages the right side of the brain is likely to get less effective treatment than someone whose stroke strikes the left side of the brain.
In a study of 20,000 patients from large hospital-based stroke registry in Germany, those with left-side strokes were more likely to be admitted to the hospital within three hours after suffering the stroke, and were also more likely to get clot-dissolving drugs quickly.
With a left-brain stroke, patients may have difficulty understanding words or speaking themselves. By contrast, the symptoms of a right-brain stroke are much more subtle. Consequently, the medical attentions and subsequent managements between patients with right and left (brain) stroke can be different. In that study, 56 percent of patients had left brain strokes, while 44 percent had right brain strokes. Diagnostic bias may happens, based on age, stroke severity, and the period from symptom onset to hospital admission.
RIGHT HEMISPHERE STROKE SYMPTOMS
A new right hemisphere symptom is reported. Five stroke patients with lesions in the perisylvian cortico-subcortical or thalamic region of the right hemisphere produced linguistically correct but semantically loose writing. The behaviour was initiated by subtle prompting and continued semiautomatically. [3]
A late onset progressive dysfluency following a right hemisphere stroke occurred in a 62-year-old male. Dysfluency was characterized by pronounced word and phrase reiterations, and sound and syllable reiterations to a lesser degree. The dysfluency occurred as a symptom of a diffuse nonspecific subcortical projection system defect related to massive infarction in the right middle cerebral artery distribution with associated atrophy. [4]
Patients in depressive state with right hemisphere stroke had symptoms of endogenous depression such as depressed mood, suicide, diurnal variation, loss of weight, and paranoid symptoms, while patients in depressive state with left hemisphere stroke had symptoms of neurotic depression such as psychic anxiety, hypochondriasis, and fatigue. [5]
STROKE HOME REFERENCES Right-brain strokes harder to diagnose Reuters Health, Jul 29, 2005 Right-Brain Strokes Often Missed, HealthDay, July 28, 2005 [3] Hypergraphia: a right hemisphere syndrome. J Neurol Neurosurg Psychiatry. 1986 Oct;49(10):1160-4. [4] Horner J et al, Progressive dysfluency associated with right hemisphere disease. Brain Lang. 1983 Jan;18(1):71-85. [5] Kikumoto O Clinical study on depressive state following stroke. Seishin Shinkeigaku Zasshi. 1990;92(7):411-34.