Confusion is a common problem after a stroke. When different areas of the brain are damaged, the pathways that control thoughts and behaviors can become jumbled. Stroke confusion is different for everyone, depending on where in the brain the stroke takes place. It can range anywhere from difficulty understanding speech to a lack of judgment about serious safety issues.
Difficulty Understanding Speech
Sometimes, a person who seems confused after a stroke is actually having problems related to their speech. When a stroke occurs in the speech centers in the brain, it can impair a person's ability to speak or understand speech. Some people have difficulty finding the right words when they speak, and may pause frequently or use the wrong word. Others may not be able to understand all of the words spoken to them. In cases of severe stroke, a person may be completely aphasic, or unable to either understand or form speech, according to the National Institute of Neurological Disorders and Stroke. Aphasia is often seen in people who have had left hemisphere strokes.
Inattention and Neglect
In some cases, a stroke can cause a person to temporarily forget about, or even completely ignore one side of the world. This is called neglect. According to the National Stroke Association, neglect is more common after a right hemisphere stroke. A person with neglect or inattention may be unaware of one side of their body, ignoring it during routine tasks such as bathing or dressing. They may also leave food on one side of their plate untouched, and bump into objects on that side that they do not see. In many cases, they are unaware that they are ignoring that side, the National Institute of Neurological Disorders and Stroke notes.
Poor Short Term Memory
Some types of stroke cause problems with a person's short term memory, or their ability to recall recent items. They may not be able to recall what they did that morning, but will likely remember the names of their family and friends. A stroke may not affect a person's ability to recall past events, but may interfere with their ability to create new lasting memories. This is more common in a right hemisphere stroke, however can affect those who have had a left hemisphere stroke as well, according to the National Stroke Association.
Difficulty Solving Problems
After a stroke, solving simple problems can be a challenge. On our stroke rehabilitation unit, we notice this most often when our patients are completing unfamiliar tasks; however, even day to day routine tasks such as dressing and walking may confuse a stroke survivor. Some people attempt to complete dressing tasks out of order, such as putting on their pants before their underwear. Others simply cannot figure out how to put the pants on, or may try to put them on their arm or head. In addition to difficulty solving routine problems, some stroke survivors become impulsive and unsafe during tasks because they are not fully aware of their new limitations. For instance, they may forget that they need help to walk, or that they cannot see well enough to drive. The National Stroke Association reports that this occurs more frequently in those with right hemisphere strokes, however it can happen regardless of where in the brain the stroke took place.