What are stroke after effects?

There are various effects and consequences that a stroke survivor experiences, both physically and emotionally. In this article, we will cover functional changes that a stroke survivor might experience. Stroke after effects can include physical changes, psychological changes, cognitive changes and more. Since no two stroke cases are the same, these can vary in type and severity.

Common physical stroke after effects

Weakness or paralysis on one side of the body

If the stroke occurs on the brain’s right side, the left side of the body and face (sparing the forehead) will be affected. It’s the opposite for a stroke that occurs on the left side of the brain. There are also differences in effects depending on which side of the brain the stroke occurred.

If the left part of the brain was affected:

  • Paralysis on the right side of the body
  • Speech/language problems
  • Slow, cautious behavioral style
  • Memory loss
  • Vision problems

If the right part of the brain was affected:

  • Paralysis on the left side of the body
  • Vision problems
  • Quick, impulsive behavioral style
  • Memory loss

Fatigue After a stroke

Everyone feels tired sometimes, but post-stroke fatigue is not a typical tiredness. The extreme tiredness that a stroke survivor experiences is called post-stroke fatigue. Unlike usual tiredness, fatigue doesn’t always improve with rest and it isn’t related to how busy or active you’ve been. Post-stroke fatigue usually starts to lessen a few months after the stroke. But for some people, tiredness may continue for years. If you’re experiencing post-stroke fatigue, talk to your medical team about ways to reduce it.


After a stroke, muscles may become stiff and tighten up. This condition is called spasticity. It refers to muscle tone which is the natural tension or contraction in a muscle that resists stretching. Spasticity makes stretching a muscle much more difficult, also causing the tendons and soft tissue around the muscle to become tight or stiff. It is important to treat spasticity because it can lead to the muscle freezing into an abnormal, painful position. If you have spasticity, talk to your doctor about the best way to treat it.


Some stroke survivors may experience seizures. Seizures occur when cells in the brain send electric signals to one another that pass along your nerves in your whole body. The electric disturbance happens due to the damage in the brain caused by a stroke. A seizure is most likely to happen within the first few days after a stroke, but can possibly occur much later. It is painless yet disorienting and upsetting, and can last few seconds or minutes. Some stroke patients may experience repeated seizures. Overall, your risk of having a seizure reduces over time after a stroke. Consult with your doctor if you think you might have had a seizure.

Psychological impact

Two of the most common psychological problems that can affect people after a stroke are anxiety and depression. To learn more about this, read in our article “Depression and anxiety after stroke”. Feelings of anger, frustration and confusion are also common as well as lack of motivation. If you haven’t received a psychological assessment from your healthcare team after experiencing a stroke, you might want to reach out to a psychological counselor to check whether you’re experiencing any emotional problems. CBT is a common type of therapy used after a stroke. It aims to change the way you approach things and helps you adopt a more positive state of mind.

Cognitive impact

“Cognitive” is a term that describes the many functions and processes that the brain uses to process information. One or more cognitive functions can be affected by a stroke. Examples are:

  • Communication
  • Spatial awareness (The natural awareness of where your body is in relation to your environment)
  • Memory
  • Concentration ability
  • Executive ability (planning, solving problems, reasoning in situations)
  • Praxis (The ability to perform skilled physical activities)

During treatment, these cognitive functions should be assessed and treatment and rehabilitation planned accordingly. You may need language and speech therapy to recover communication skills, use memory aids such as writing a diary, planning daily tasks to regain your memory, etc. You will find that most of your cognitive functions will return with time and treatment, but they may not be the same they were before.

One of the risks after a stroke is developing vascular dementia. This is a condition that describes problems with planning, judgment, memory and other thought processes due to brain damage from impaired blood flow to your brain.

Movement problems

When body muscles cannot properly perceive messages sent by the brain, this causes movement problems like paralysis and muscle weakness. Muscle weakness makes supporting the body difficult, causing movement and balance problems. A stroke can also cause weakness or paralysis on one side of the body, depending on which side of the brain was affected. This results in coordination and balance problems. To regain movement function, a stroke patient will usually need a rehabilitation program. To learn more about rehabilitation after stroke, read in our article “What are the options for stroke rehabilitation?”.

Communication problems

Communication problems are very common after a stroke. Around one-third of stroke survivors have problems with speaking, reading, writing and understanding what other people say to them. Most common communication problems are as follows:

  • Aphasia affects your ability to speak and understand what others say. It can also affect your ability to read and write. It happens when you’re no longer able to understand or use language. Aphasia is a common problem after stroke and around a third of stroke survivors have it.
  • Dysarthria happens when you’re not able to control the muscles in your face, mouth and throat too well. This creates difficulty to speak clearly. Your speech may become slurred or slow or your voice may sounds quiet.
  • Apraxia of speech is when you can’t move the muscles in your face, mouth or throat in the order you need to when you’re speaking. This can make it difficult for other people to understand you.

For assessment of your communication abilities, you should seek out a speech and language therapist. They will help you with regaining your lost communication abilities. Speech and language therapy might include:

  • Exercises to improve your control over your speech muscles
  • Use of communication aids – letter charts, electronic aids
  • Use of alternative communication methods, i.e, gestures or writing

Although it can be assumed that communication problems affect your intelligence, it is mistaken. If you experience communication problems, you simply have problems with the process of speaking and understanding language.

Swallowing problems

Damage to the area of your brain that controls eating and swallowing can cause you to have problems with the respiratory system. When the damage caused by a stroke interrupts your swallowing reflex, this is called dysphagia. If the muscles in your throat, tongue or mouth aren’t able to direct food correctly, food and liquid can get into the airway and settle in the lungs. This can cause serious complications, like infection and pneumonia. If you are experiencing issues with swallowing, you might need to be fed with a feeding tube during the first phase of your recovery. While dysphagia is a common symptom after a stroke, it usually improves with time.

Visual problems

After stroke, you might experience changes in your vision. Visual problems occur when the parts of the brain that receive, process and interpret information sent by the eyes is impaired. Some of the stroke after effects that affect vision include:

  • Problems with seeing clearly
  • Loss of ability to judge space and depth
  • Loss of half the field of vision (Only being able to see the left or right side of what’s in front of you)
  • Double vision (When control of eye muscles is affected)

If you are experiencing vision problems after a stroke, you should be referred to an eye specialist called an orthoptist. An orthopist will assess your vision and suggest possible treatment options.

Bladder and bowel control

Some strokes may damage the part of the brain that controls the bladder and bowel. This can cause loss of control over these functions, resulting in incontinence. You might need to go to the bathroom more often, urinate during sleep, etc. Some stroke survivors may regain bladder and bowel control quite quickly. But if you still experience problems after leaving hospital, you should seek medical help from your hospital or general practitioner.

The aforementioned stroke after effects can certainly be a lot to deal with. Yet there is hope to regain your lost functions and abilities after a stroke with a proper treatment plan, self motivation and time. New routines will become second nature all of a sudden. Rehabilitation can build your strength and confidence, and seeing your own improvement will undoubtedly provide you with motivation. Having a strong support system and medical team will also be key to help you recover. It is important to remember that recovery from stroke is not a linear process, and staying encouraged can sometimes be hard. Yet your own motivation and active participation in recovery are the most important aspects to achieve progress.

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