Study finds right-brain strokes harder to diagnose

Jul 31 2005

According to a new German study, the findings suggest that because of differences in symptoms, strokes affecting the right side of the brain may be under diagnosed compared with to those affecting the left side.

Due to the way the brain and body interact, strokes on the left side of the brain can cause movement problems on the right side of the body and visa-versa, but as these signs might not always be obvious, doctors also look for other symptoms.

Patients who have suffered a left-brain stroke may have difficulty understanding words or speaking themselves, while the symptoms of a right-brain stroke are much more subtle.

Lead author Dr. Christian Foerch, from Johann Wolfgang Goethe University in Frankfurt, and colleagues say that correctly identifying the symptoms of right-brain stroke is critical for optimal treatment, and they add their study suggests differences in medical attention and subsequent management between patients with right and left brain stroke, may be required.

The difference in stroke recognition can be explained by the symptom scoring sheets doctors use to evaluate stroke patients, as many of these sheets are simply better suited to detecting the symptoms of a left-brain stroke rather than a right-brain one.

The study findings, are based on an analysis of data from a large hospital-based stroke registry in Germany, and data from more than 20,000 patients were included in the analysis.

The researchers found that fifty-six percent of patients had left brain strokes, while 44 percent had right brain strokes.

The authors believe a diagnostic bias may have been involved because age, stroke severity, and the period from symptom onset to hospital admission were all significantly linked to left-brain stroke.

In a related editorial, Dr. John N. Fink, from Christchurch School of Medicine and Health Sciences in New Zealand, comments that contrary to what might be believed, stroke diagnosis is not simple, and says it comes down to physicians who assess patients with stroke to train other physicians, and organize stroke services to improve the standard of diagnostic performance.

The study findings appear in the current edition of The Lancet.