My gran and her pareital stroke

I cannot remember if I mentioned it on this board or not but last week my gran had something weird with her and ended up in hospital.

Anyway it now seems to be that the current diagnosis is that it was a stroke in the pareital lobe. I don’t know anything more than this.

She is apparently in various stages between entirely (apparently) lucid, to a selfish person (and she was the least selfish person you would ever know, albeit a bit cynical), to a loon.

Is the fact she is quite often totally compos mentis a good sign in terms of recovery?

I took a look on the brain diagram and that is a HUGE part of the brain. But is there anything specific that I can be told about what to expect/not expect?

Also it was her right lobe if that helps much. Otherwise I know very little. And I will probably not see her in person till Christmas unless there is a large consensus I shoud see her soon?

There is really not very much to go on here. Problems caused by brain damage can vary widely depending on the particular location and size of the damaged area. Assuming she does not have another stroke (and I can’t tell whether that is a likely or unlikely assumption), she will probably get better rather than worse over time, but how much better is also impossible to predict from the information you give (and very likely impossible even for her doctors). The fact that she often does seem “compos mentis” probably is a good sign, but a full recovery is unlikely.

The parietal lobe, especially the left one, is particularly concerned with people’s understanding of spatial relations and the layout of things in the space around them, and damage there often has effects on spatial cognition (although it can have other results too).

Some of these effects of parietal damage can be particularly weird. One quite common effect of right parietal damage that I happen to know a bit about is left-hemineglect (aka unilateral neglect), in which patients, who may otherwise seem reasonably normal and lucid, fail to pay any attention to the left side of the space around them. (As you probably know, the left half of teh brain deals with the right side of the body, and vice-versa.) They will do things like failing to eat any of the food on the left side of their plate (while complaining that they are hungry) or putting makeup or shaving only on the right side of their face. In extreme cases, they may seem not to hear anything said to them by people standing to their left, although they hear someone standing to their right perfectly well, and respond normally. If asked to draw a picture of a clock face, they will put all or most of the numbers on the right side, and fill in none, or very few, of those that belong on the left. Here you can see some drawings made by people with hemineglect (originals on the left, and patient’s copies on the right).

People will quite often recover, or partially recover, from hemineglect over time, and there are treatments, such as spending time wearing prism-glasses, that seem to help to speed this process up, but no guarantees, I think

Oddly, damage to the left parietal cortex only very rarely leads people to neglect the right side of space. Damage to the left parietal cortex is much more likely to result in language difficulties, however. (This is all assuming we are talking about a right-handed person. With left handers, things get confusing. In some cases you may get a neat reversal of which side damage affects what, but not always by any means.)

Another even weirder symptom often associated with parietal damage, and often associated with hemineglect, is anosognosia, in which patients steadfastly deny that there is anything wrong with them, when there manifestly is. The parietal brain damage may also cause paralysis, for instance of the left arm. If they also have anosognosia, they may deny that there is anything wrong with their arm, and if asked to move they will either insist that they have moved it (when they manifestly have not) or may make some excuse about why they don’t actually want to do so at the moment.

Another oddity is that both of these problems can often be very temporarily fixed by squirting ice cold water in the patient’s left ear. When this is done they may become aware of things to their left again, and our anosognosic would probably realize that her arm is paralyzed. However, after a short while the anosognosia would return, and she would again deny that there was anything wrong with her arm. Although she would probably remember the ear-squirting incident pretty well, she would not remember that it caused her to be aware of her paralysis.

Note, please, that I am not saying that your gran will suffer from either hemineglect or anosognosia, just that they (especially hemineglect, ranging from mild to severe) are fairly common results of right parietal damage. The specific issues she may suffer (and prospects for recovery) will depend on the specific location and extent of the lesion.

Also, be advised that I am not a (medical) doctor.

While not exactly a stroke, I had a demyelination in my left parietal lobe 12 years ago. The resultant swelling left me with a dead area approximately 2.5 cm x 2 cm on my MRI.

I lost all physical control of my right side and had to relearn how to walk, talk, and use my arm. Luckily, neuropsychiatric testing showed no other deficits or behaviour changes. I still have minor physical issues, but it would be unlikely for anyone other than close family to notice.

It’s amazing how little we really know about the brain!

I had a stroke 11 years ago that affected my right parietal, frontal, and temporal lobes (ischemic CVA due to blockage of right MCA). There are several predictors for stroke recovery:

  1. Has she had any previous brain injury? - if there is pre-existing damage a stroke will only make it worse (brain doesn’t heal or grow back)
  2. How soon did she get treated? -the faster you get treated, the fewer brain cells die
  3. How old is she? - the younger you are, the more plastic your brain is. So, it’s easier to build new neural pathways.

I had no previous trauma, was found immediately and got to the ER within 30 minutes of my stroke and I was 24 so I have basically recovered 99.9%.

I think the particular problem I had with my parietal damage was spatial. For example, it took me months to be able to fill a glass with water. I had trouble judging what was full. And being cleared to drive took months too. Now, my body coordination is horrible. Judging where my body is in space is difficult. I did struggle with neglect of my left side. I actually used to throw my left arm off my bed because it was “in the way”. I am better now but it still takes effort for me to recognize to pay attention to my left side.

Your gran will probably spend time in the hospital ICU until she is stable and then be sent to rehab. Also, if a doctor tells you that what she gets back in the first 3 days post-stroke is a good indicator of her recovery, I want to let you know that is completely wrong. I got back a lot of functionality months and years out.

My dad visited her the other day. She was apparently totally normal for half an hour at least.

Then as it came to the end of the visit, she told him about how she’d been to the shop a few hours before to buy boiled ham and [something else I forget], but they’d been out of stock.

Of course, she’d been in hospital all the time.

I am still rather upset about this. I will be going to see her next weekend hopefully.