Aggressive or combative behavior is a common secondary effect during the acute stages of stroke, especially if the frontal lobe has been affected.
The reason is simple. Stroke impacts the brain, and the brain controls our behavior and emotions. You or your loved one may experience feelings of irritability, forgetfulness, carelessness or confusion. Feelings of anger, anxiety or depression are also common.
Having a stroke can affect your emotions and personality. You may laugh or cry for no reason. These changes can be hard to adjust to, especially for those closest to you. Emotional and personality changes can get better with time.
After a stroke you might find you experience anger much more frequently, have less control over your outbursts and/or get angry over things that would not normally cause you to feel that way. You are likely to direct this anger at your family and carers.
"Anger and aggression seems to be a behavioral symptom caused by disinhibition of impulse control that is secondary to brain lesions, although it could be triggered by other peoples'''' behavior or by physical defects." Kim said anger and aggression and another symptom common with recovering stroke patients are " ...
Anger and aggression
Many people find themselves getting frustrated and angry after their stroke. You may lose your temper for no reason or get angry about things that never would have made you feel that way before. If your anger turns into aggression, you may shout, throw things, threaten people or try to hurt them.
In fact, about one-third of all stroke survivors will experience emotional difficulties, and many others may demonstrate personality changes or inappropriate behaviors. These shifts in mood and behavior are often difficult for both stroke survivors and their loved ones.
First and foremost, it can help to remind yourself that a stroke survivor's anger is often not directed at you but rather at their limitations. Even if the person is reacting in a way that is hurtful to you, try your best to practice empathy for the survivor and also practice compassion for yourself, too.
Of the 145 stroke patients studied, 32% described an inability to control anger or aggression up to a year after their stroke. Sometimes the emotional eruptions occurred spontaneously and without provocation, and in other cases a family member may have prompted the unusual response.
Around 70%reported that their TIA had long- term effects including memory loss, poor mobility, problems with speech and difficulty in understanding. 60%of people stated that their TIA had affected them emotionally. There is no way to tell whether a person is having a TIA or a stroke when the symptoms first start.
Transient ischemic attacks are commonly referred to as “mini-strokes,” but this does not make them any less serious than major strokes. In fact, a recent study has found that around 30% of patients who have transient ischemic attacks go on to develop the symptoms of post-traumatic stress disorder (PTSD).
The good news is you absolutely can live a full life after a mini-stroke. Here's how. Like strokes, mini-strokes occur when a blockage occurs in a major artery to your brain, disrupting the flow of blood and oxygen. The difference is in a mini-stroke, the disruption lasts only minutes, so there's no permanent damage.
Introduction. Brain magnetic resonance imaging (MRI) is the preferred and most sensitive modality after transient ischemic attack (TIA) or minor stroke. It should include diffusion-weighted imaging (DWI) and should be completed within 24 hours of symptom onset1,2; its use is 3-fold.
Combative or aggressive behavior after stroke is a negative secondary effect frequently observed in survivors, especially in the acute stage of recovery. This can be a temporary phase or, in some cases, can be long-lasting and a sign of damage to specific areas of the brain.
Another personality change that occurs after stroke is impulsiveness. This is characterized as the inability to think ahead or understand consequences. Impulsiveness is more commonly seen in people with right-side or a frontal lobe stroke.
If your loved one is being self-centered after stroke, understand that it might be caused by damage to the brain and that it's not necessarily their fault. Luckily, empathy can be learned, and the brain can be rewired to recover this cognitive-emotional skill. Self-centered behavior can be managed, so don't lose hope!
Personality Changes are Common
After a stroke, you might feel more anxious, lose interest in hobbies or laugh or cry uncontrollably. These symptoms may be upsetting to you and your loved ones and can affect quality of life.
According to the study authors, anger or emotional upset was linked to an approximately 30% higher risk of having a stroke within one hour of experiencing those emotions. Another potential stroke trigger revealed by the study was heavy physical exertion, although the evidence was less convincing.
Relationship problems
Other things can affect intimacy, like communication difficulties and low mood or anxiety. Having a stroke can affect your confidence and self-image. You may both find it difficult to talk about how you feel, because you think you should 'stay strong' for your partner.
A review of studies published after 1980 shows alarmingly high post-injury divorce rates ranging from 48% to 78%. There is little doubt that brain injury can strain marriages. Spouses often take on many of the injured person's responsibilities, though they may have little experience with their new responsibilities.
Another study went further to show that high quality marriages increased the length of survival after stroke more than simply being married (2). In other words, the benefits of marriage may go beyond Hallmark Channel's depiction of “happily ever after”, and have real health benefits as well.
Families of stroke patients sometimes report that their loved one seems uncaring or uninterested in what they are experiencing. That lack of empathy can cause hurt feelings and damage relationships.
Personality changes can be common after a stroke. Some changes may be due to damage in the brain. Others may be caused by the stress of dealing with life changes and physical limitations from the stroke. Some personality changes may get better on their own while others require medication or therapy.
Childlike behavior is one of many different behavioral changes people can experience after a stroke. It may or may not be permanent depending on the severity of damage and how it is managed. Generally, the more severe the damage to the brain, the more significant the behavioral changes are.
If the stroke occurs in the left brain, the survivor may be more depressed, which can also affect desire. It's possible (but rare) that a stroke can increase sex drive and even cause the survivor to become hypersexual and have an inappropriate approach to sex.