pls help me know about left sided stroke

[rosearias1]

hi there, during our related learning experience in the hospital i got the chance to handle patient who suffered from left sided stroke. the manifestations i had seen in him was right sided hemiparesis in face, arms and legs. my clinical instructor contest me saying that left sided stroke manifestations in face must be on the left side also while right side only for extremity. how can i prove to him that my findings were really true because that was evidenced based. i know certain explanation about the decussation of motor fibers in the corticospinal tract and all that, but how would i explain it to him clearly that it is really possible.. is it really possible to have right sided facial weakness to patient suffering from a left sided stroke? pls help me.. thanks..

[NRSKarenRN, BSN, RN]

allnurses has a great search engine located opposite our name above on page. click on down arrow next to search button, can go to medline plus for disease/ encyclopedia or google search on topics.

use search term: "cerebral vacular accident left side vs right side affects"

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stroke - wikipedia, the free encyclopedia

the patricia neal rehabilitation center - stroke program (cva)

nursing care for neurological patients

[Fig77]

I wrote a small pathophysiological explanation but you migh need more to convince a professor :

There is hemiplegia and there is hemiparesis. The difference is that hemiplegia is severe because it's a total paralysis of one side of the body. Hemiparesisnis simply the weakening of one part of the body. And the usual suspect for both of them is the stroke, as is in your case. stroke in the anteromedial cerebral artery leads to the infarction of motor neuron strips in the anteror frontal cortex. Frontal cortex is probably what makes us different from animals because in humans frontal lobe is larger. It is responsible for higher mental functioning such as communication, motor skills for movement of body (or body parts), judgement and conception.

Complete infarction could lead to total loss of opposite side facial, tongue, arm and leg nerves to not function. The opposite side effect happens because the nerve fiber tracts also known as corticospinak tracts cross over at the brain stem (paritcularly at medulla) forming pyramidal shapes above spinal cord.

Now it is possible for our face to have that opposite sided effects even though it is kinda hard to imagine motor nerves at brain stem going up towards face. Our facial expressions is a good example. The difference with facial hemiparesisnis that the cross over of fiber tracts that activates facial nerve ganlion happens at pons, which is above medulla but within the brain stem.*