What are the symptoms of a right basal ganglia stroke?

Symptoms of Right Basal Ganglia Stroke

A right basal ganglia stroke typically presents with left-sided motor symptoms including hemiparesis, dystonia, and movement disorders, along with potential cognitive and emotional disturbances such as depression and blunted emotional responses.

Motor Symptoms

The most common symptoms of right basal ganglia stroke include:

• Left-sided hemiparesis (weakness on the contralateral side) 1
• Abnormal muscle tone - may present as hypertonia or rigidity 2
• Movement disorders including:
  • Dystonia (involuntary muscle contractions causing twisting movements) 3
  • Parkinsonian features (tremor, rigidity) 2
  • Choreic movements (irregular, flowing movements) 2
  • Dysarthria (difficulty with speech articulation) 2

Cognitive and Emotional Symptoms

Basal ganglia involvement extends beyond motor control to cognitive and emotional functions:

• Emotional blunting - reduced intensity of emotional experiences 4
• Depression - frequently associated with left basal ganglia damage 4
• Cognitive impairments - the basal ganglia participate in multiple circuits with cognitive areas of the cerebral cortex 5
• Executive function deficits - particularly with decision-making and behavioral regulation 3

Diagnostic Imaging Findings

MRI typically shows:

• Hyperintensity on T2-weighted images in the region of the basal ganglia 2
• Hypointensity on T1-weighted images in the affected area 1
• The abnormal region on T2-weighted images is usually more extensive than that observed on T1-weighted images 1
• Possible ipsilateral midbrain atrophy on the side of the lesion 1

Special Considerations in Children

In pediatric populations:

• Basal ganglia stroke can occur after mild head trauma in infants with mineralizing angiopathy of lenticulostriate arteries 6
• Children with post-stroke dystonia may experience greater levels of anxiety and depression compared to those with similar stroke patterns but no dystonia 3
• Male sex and iron deficiency anemia may be risk factors for basal ganglia stroke after minor trauma in infants 6

Clinical Course and Prognosis

• Motor sequelae occur in approximately 35% of patients 1
• Secondary dystonia may develop in some patients 1
• Mental health outcomes, particularly anxiety and depression, should be monitored, especially in patients who develop post-stroke dystonia 3
• Cognitive and motor outcomes may be independent of each other in patients with post-stroke dystonia 3

Early recognition of these symptoms is crucial for timely intervention and management to improve outcomes in patients with right basal ganglia stroke.