From the Research
Yes, the forehead can be affected in a stroke, particularly in cases where the brainstem is involved. During a stroke, facial weakness or paralysis often occurs, which can involve the forehead muscles. However, the forehead is typically less affected in the most common type of stroke (middle cerebral artery stroke) compared to the lower face. This is because forehead muscles receive nerve signals from both sides of the brain, while the lower face is primarily controlled by the opposite side of the brain. This difference creates what doctors call the "forehead-sparing pattern" - where a stroke patient may still be able to raise both eyebrows despite weakness on one side of the mouth. This pattern helps distinguish stroke from other conditions causing facial weakness.
Key Points to Consider
- The forehead muscles can be involved in a stroke, especially in brainstem strokes 1
- The "forehead-sparing pattern" is a characteristic feature of stroke, where the forehead is less affected than the lower face 2
- Sudden facial drooping, arm weakness, speech difficulties, or other neurological symptoms can be warning signs of a possible stroke 3
- Intravenous thrombolysis with alteplase or tenecteplase can be effective in treating ischemic stroke, but the decision to use these medications should be made on a case-by-case basis, considering the individual patient's risk factors and medical history 4, 5
Importance of Early Recognition and Treatment
It is crucial to recognize the signs and symptoms of a stroke early and seek emergency medical attention immediately. Early treatment can significantly improve outcomes and reduce the risk of long-term disability or death. The most recent study on the topic, published in 2025, highlights the importance of timely treatment and the potential benefits of intravenous thrombolysis in patients with posterior circulation ischemic stroke 4.
Clinical Implications
In clinical practice, it is essential to be aware of the potential involvement of the forehead in stroke and to consider this when evaluating patients with suspected stroke. A thorough understanding of the underlying anatomy and pathology of stroke can help guide diagnosis and treatment decisions. By prioritizing early recognition and treatment, healthcare providers can improve outcomes and reduce the burden of stroke on individuals and society.