--- title: "Left or Right-Sided Stroke: Which Is More Dangerous?" description: "How strokes in the left and right hemispheres differ: language, attention, neglect and what this means for rehabilitation." date: 2026-10-24 lastmod: 2026-11-02 canonical: https://drmotiva.com/en/articles/left-or-right-sided-stroke/ lang: en --- # Left or Right-Sided Stroke: Which Is More Dangerous? Families often ask which side of stroke is more serious. Neither side is simply more dangerous: severity depends mainly on the size and location of the damage. The two sides, however, tend to cause different problems. ## Left-hemisphere stroke - Weakness of the right side of the body - Language problems (aphasia) in most people, because language is located in the left hemisphere [3] - Difficulty with reading, writing and calculation - Sometimes difficulty planning movements (apraxia) Further reading: the [guide “Stroke”](https://drmotiva.com/en/guides/stroke/) and the articles [Stroke Rehabilitation: Ischaemic and Haemorrhagic Stroke](https://drmotiva.com/en/articles/stroke-rehabilitation/) and [Depression and Psychological Problems After Stroke](https://drmotiva.com/en/articles/depression-after-stroke/). ## Right-hemisphere stroke - Weakness of the left side of the body - Spatial neglect: ignoring the left side of space or the body, which is more common and more severe after right-hemisphere stroke [1, 2] - Reduced awareness of the deficits - Problems with attention, spatial orientation and judgement ## What this means for rehabilitation Right-hemisphere strokes with neglect can make rehabilitation more challenging because of safety and awareness issues, while left-hemisphere strokes with aphasia make communication harder. Both need targeted therapy. See [Neglect after stroke](https://drmotiva.com/en/articles/neglect-after-stroke/) and [Aphasia after stroke](https://drmotiva.com/en/articles/aphasia-after-stroke/). ## The ‘crossed’ pattern Each hemisphere (half of the brain) mainly controls movement and sensation on the opposite side of the body. A stroke in the left hemisphere therefore typically causes weakness of the right arm and leg, and a stroke in the right hemisphere causes weakness on the left. Strokes in the brainstem or cerebellum (the parts at the back and base of the brain) can produce different patterns, such as problems with balance, coordination, double vision or swallowing, sometimes affecting both sides. ## How it is assessed The PM&R physician examines movement, sensation, vision, language, attention, memory, planning and behaviour, and reviews the brain imaging. Specific tests look for aphasia (language disorder), apraxia (difficulty planning learned movements), neglect (not noticing one side of space) and problems with judgement or insight. These findings shape the rehabilitation goals and safety advice. ## Different challenges in daily life People with left-hemisphere stroke may find communication frustrating and may be slower and more cautious. People with right-hemisphere stroke may underestimate their difficulties, act impulsively and be at higher risk of falls, even when they speak fluently. Both groups may have depression, fatigue and memory problems. ## What families can do - With aphasia: speak slowly, use short sentences and give time to answer - With neglect: approach from the affected side gradually as advised, and place reminders such as a coloured line on that side - With impulsivity: supervise risky tasks such as walking alone, using the stove or crossing the road - In all cases: keep routines simple, reduce distractions and share observations with the team ## When to see your physical medicine and rehabilitation specialist After acute hospital care, the rehabilitation process is best led and advised by a physician specialised in physical medicine and rehabilitation (PM&R, also called physiatry). At home, too, it is worth consulting a PM&R specialist, who examines the patient, sets goals and guides therapy and supportive treatments together with the physiotherapist and the wider team. Ask for a review if: - function is getting worse instead of better, or progress has stalled for several weeks - new pain, stiffness, swelling or falls appear - mood, sleep, swallowing or bladder control change - you are wondering whether a robotic or other advanced therapy might be suitable Whether robotic or other advanced therapies are suitable is decided by a PM&R specialist focused on neurorehabilitation. Prof. Dr. Engin Çakar works in this field and can be consulted online or in person; otherwise, consult a PM&R specialist near you. **Call emergency services immediately** for sudden new weakness, facial drooping, difficulty speaking, a severe headache or loss of consciousness: these can be signs of a new stroke. ## Frequently asked questions **Is a right-sided stroke milder because speech is preserved?** Not necessarily. Neglect and reduced awareness can greatly affect independence. **Does handedness matter?** In most right-handed and many left-handed people, language is in the left hemisphere. **Can a person have symptoms on both sides?** Yes, for example after strokes in both hemispheres or in the brainstem. The rehabilitation plan is adapted to all deficits present. **Does the side of the stroke affect driving?** Driving depends on vision, attention, reaction time, judgement and movement, whichever side is affected. Fitness to drive is assessed individually and must follow local regulations. ## Assessment and contact You can request an appointment or a second-opinion review of existing reports and imaging: [Contact & second opinion (WhatsApp)](https://drmotiva.com/go/wa?l=en&t=&loc=inline_contact&p=%2Fen%2Farticles%2Fleft-or-right-sided-stroke%2F). This page is general health information. Diagnosis and treatment decisions are made individually after examination. ## Sources 1. Esposito E, et al. Prevalence of spatial neglect post-stroke: A systematic review. Ann Phys Rehabil Med. 2021. [PMID: 33246185](https://pubmed.ncbi.nlm.nih.gov/33246185/) 2. Gammeri R, et al. Unilateral Spatial Neglect After Stroke: Current Insights. Neuropsychiatr Dis Treat. 2020. [PMID: 32021206](https://pubmed.ncbi.nlm.nih.gov/32021206/) 3. Brady MC, et al. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev. 2016. [PMID: 27245310](https://pubmed.ncbi.nlm.nih.gov/27245310/)