The Effects of a Frontal Lobe Stroke

If you or your loved one has had a stroke involving the frontal lobe of the brain, then you might be seeing some very noticeable effects, such as leg weakness, arm weakness, or memory loss.

The effects of a stroke differ depending on which region of the brain is involved. The brain's frontal lobe is relatively large and it controls many important functions in everyday life. A frontal lobe stroke can cause a variety of symptoms and long-term effects which range from weakness to lack of motivation.

There are four main categories of problems that can occur after a frontal lobe stroke. If you or a loved one has experienced a frontal lobe stroke, you may experience any combination of these effects.

• Muscle weakness
• Speech and language problems
• A decline in thinking skills
• Behavior and personality changes

The frontal lobe of the brain controls the movement of the opposite side of the body. A stroke that causes weakness (hemiparesis) or paralysis (hemiplegia) may produce obvious arm or leg weakness, but it can also cause any of the following symptoms as well.

• Dysphagia or difficulty swallowing
• Ataxia or damage to the body's ability to coordinate movement (balance, posture, walking)
• Urinary incontinence or inability to urinate due to loss of muscle control

There are several language areas of the brain, and they are located in the frontal lobe, the temporal lobe, and the parietal lobe.

Language function is located on one side of the brain. The side of the brain that controls language is called the dominant side, which is most often the left side. The comprehension of language is controlled by a region in the dominant temporal and parietal lobes of the brain, while fluent speech is produced by a region in the dominant frontal lobe of the brain. In addition to language function, there are several other key differences between the left and right sides of the brain.

This speech pattern characteristic of a dominant-sided frontal lobe stroke is called Broca’s aphasia.

The cognitive changes after a frontal lobe stroke may be subtle. Some people who repeatedly experience several small strokes involving the frontal lobes of the brain may develop a type of dementia called vascular dementia. Characteristic cognitive changes caused by a frontal lobe stroke include the following:

• Lack of initiative, mood changes, and inattentiveness
• Difficulty solving problems (goal-directed behavior) in different realms of cognition including psycholinguistic, constructive, logical, and arithmetical

Sometimes, behavioral changes may develop after a frontal lobe stroke. Some specific behavioral changes include excessive jealousy, loss of sense of humor or changes such as lack of empathy. Other common behavioral changes after a frontal lobe stroke include the following:

• Profound lack of initiative and motivation
• Spontaneous expression of rude or odd remarks
• Irritability
• Carelessness and apathy
• Inappropriate and seemingly random persistence and repetition of certain behaviors
• Bowel or bladder emptying when it is not socially appropriate

The left and right frontal lobes of the brain are large regions at the front of the brain that extends back towards the middle of the brain, accounting for approximately 1/3 to 1/2 of the cerebral cortex. We have a left frontal lobe and a right frontal lobe.

A frontal lobe stroke is caused by interruption of blood flow through any of the following arteries:

• The internal carotid artery or its branches
• The middle cerebral artery or its branches
• The anterior cerebral artery or its branches

Usually, a frontal lobe stroke involves only the left frontal lobe or the right frontal lobe because each side receives blood from arteries on its own side.

A frontal lobe stroke can be large or small, depending on whether interruption of blood flow occurs in one of the large blood vessels or in a small branch of a blood vessel.

Because the frontal lobes are substantial in size, specific regions of the frontal lobe may be damaged by a stroke, while other regions are spared. If there is a great deal of swelling or bleeding immediately after a stroke, the short-term phase may be uncertain as the bleeding and swelling slowly resolves.

A frontal lobe stroke can produce a variety of symptoms, some of which are more clearly related to the stroke (weakness) and some of which can be confused with depression or dementia. When a stroke produces weakness on one side of the body, physical rehabilitation is an essential part of recovery.

When a stroke produces dementia, it can be difficult to distinguish the difference between a stroke and dementia. The medical management of the two conditions is not the same, and if you understand the differences and similarities between a stroke and dementia, it will help you know what to expect.

Most people who have had a frontal lobe stroke are able to experience some recovery of skills. The improvement is expected to take time and may be sporadic or irregular at times. It is important not to be discouraged, because often, stroke survivors continue to improve even after stabilizing.