Right Brain Strokes
Right-Brain Strokes Get Earlier Attention

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.


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]

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
[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.