Different variables between patients with left and right hemispheric ischemic stroke

Hirono Ito1, Osamu Kano, Ken Ikeda

  • 1Department of Neurology, Toho University Omori Medical Center, Tokyo, Japan.

We studied whether some variables differ between patients with right and left hemispheric ischemic stroke. A total of 383 cases were obtained from our department-based records between April 2003 and March 2006. Age distribution, sex, intracranial localization of anterior (carotid artery distribution) or posterior (vertebrobasilar artery distribution) circulation, mechanism subtypes according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria, cerebrovascular risk factors, and time from clinical onset to admission were analyzed between the right and the left hemispheric ischemic stroke groups. In all, 200 patients had left hemispheric stroke and 183 patients had right hemispheric stroke. Age, sex, vascular risk profile, stroke subtypes, and mechanism subtypes were not statistically different between patients with right- and left-sided ischemic stroke. Time interval from neurologic onset to admission within 6 hours was significantly associated with left hemispheric cerebral infarction. Furthermore, patients with left-sided small-vessel occlusion visited our hospital earlier, up to 6 hours as compared with patients with right-sided small-vessel occlusion (P < .05). We suppose that patients with right-sided small-vessel occlusion may take time to be aware of neurologic deficits because of nondominant language or hand function. Our data indicate that different medical attention exists between patients with right and left hemispheric ischemic stroke. We should pay more attention to the difficulty in recognizing the neurologic deficits in patients with right hemisphere ischemic stroke, so that those patients delay hospital visit.

Related Concept Videos

Lateralization01:28

Lateralization

Brain lateralization refers to the division of mental processes and functions between the two hemispheres of the brain, a phenomenon that optimizes neural efficiency and underpins complex abilities in humans. This specialization allows each hemisphere to perform tasks where it has a comparative advantage, facilitating more refined cognitive capabilities across different domains.
Cerebral Hemispheres01:05

Cerebral Hemispheres

The human brain, a complex organ, is functionally divided into two cerebral hemispheres—left and right. These hemispheres are interconnected by a structure of paramount importance, the corpus callosum. This substantial bundle of neural fibers is not just a bridge between the hemispheres but a crucial element for the brain's comprehensive functioning. It enables efficient communication between the two hemispheres, allowing each side of the brain to control and receive sensory and motor...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...