Parietal Lobe Stroke Symptoms and Recovery

A parietal lobe stroke is a type of stroke that occurs in the parietal lobe of the brain. This is the part of the brain responsible for receiving and processing sensory input such as touch, pressure, temperature, and pain. The parietal lobe enables spatial awareness (the awareness of your body in space) and proprioception (the ability to orient your body as it moves through space).

A parietal lobe stroke affects these sensory domains, causing a loss of proprioception as well as language or reading problems, changes in behavior, and visual disturbances. The treatment varies by the severity of the stroke but typically involves physical, occupational, and speech therapy.

This article describes the range of symptoms that can occur with a parietal lobe stroke and the various factors that increase the risk. It also explains how strokes are diagnosed and treated and what to expect during rehabilitation and recovery.

What Are the Symptoms of a Parietal Lobe Damage?

The symptoms of a parietal lobe stroke can vary by the degree, duration, and location of the blood obstruction, as well as the extent of the brain damage.

The parietal lobe itself is comprised of two lobes roughly the size of a fist. The left hemisphere is typically the dominant side and serves as the language center for most people. The right hemisphere tends to be non-dominant and is responsible for things like spatial processing and cognition (the ability to think, perceive, and reason).

Language Impairment

For most people, damage to the left hemisphere of the parietal lobe can cause aphasia (the loss of ability to understand or express speech) or alexia (the inability to read despite recognizing letters).

If damage extends to the temporal lobe (located at the side of the brain), there may also be problems understanding language.

Damage extending to the frontal lobe may interfere with speech planning, making it difficult to string together syllables or use complex words.

Loss of Spatial Awareness

Damage to the right hemisphere of the parietal lobe may result in the loss of spatial awareness on the opposite side of the body, also known as hemispatial neglect.

If this occurs, a person may have no awareness of what’s happening on the left side of a space. This can cause a person, for example, to shave or apply makeup to only the right side of the face and behave like the other side doesn't exist. In some cases, a person may look at their left arm or leg and not even realize it is theirs.

Hemispatial neglect, also known as hemiagnosia, may be accompanied by anosognosia, or the complete unawareness that anything is physically wrong.

Hemispatial neglect may affect up to 82% of people following a right hemisphere stroke in the early acute stages.

Vision Changes

Partial vision loss may also occur after a parietal lobe stroke, making it difficult to see and recognize objects. A parietal lobe stroke is most likely to result in inferior quadrantanopia characterized by the loss of the left or right lower fields of vision of both eyes.

Loss of Proprioception

After a parietal lobe stroke, a person's proprioception may not function properly. When trying to walk, for example, they may have no idea where their left leg is in relation to the ground.

This can lead to "difficulty grading movement," meaning a misjudgment in how much to flex or extend muscles during a movement. This can cause you to lose your ability to judge how heavy or light an object is, or how far you need to reach to grab it.

People with proprioception dysfunction tend to stomp their feet when walking and bump and crash into obstacles as they become less able to judge their movements in space.

Impairment of Executive Function

The parietal lobe interacts with the frontal lobe, the part of the brain responsible for executive function—the ability to think abstractly and make decisions based on analysis and learned behaviors.

With a parietal lobe stroke, the sensory input from the parietal lobe to the frontal lobe may be impaired, causing apraxia (the inability to perform movements on command). This can result in a loss of coordination or hesitancy of movement.

Gerstmann Syndrome

A parietal lobe stroke in the dominant hemisphere, usually the left, can result in Gerstmann syndrome, a neuropsychiatric disorder characterized by four major symptoms:

• Difficulty with left-right orientation
• Agraphia (difficulty writing)
• Acalculia (difficulty with calculations)
• Finger agnosia (inability to distinguish fingers)

These characteristic symptoms may also be accompanied by aphasia, particularly in adults.

Gerstmann syndrome is a condition associated solely with the parietal lobe. In addition to stroke, Gerstmann syndrome may be caused by a brain tumor, multiple sclerosis, or an aneurysm of the middle cerebral artery.

Causes and Risk Factors of Parietal Lobe Stroke

Stroke is caused by an interruption of the blood supply to a part of the brain. It may be due to the rupture of a blood vessel (hemorrhagic stroke) or a blocked artery (ischemic stroke). The sudden lack of blood deprives the brain of oxygen and vital nutrients, causing tissues to die within minutes.

A parietal lobe stroke occurs when one or more of the blood vessels that supply the parietal lobe either bleeds or becomes blocked. The parietal lobe receives its blood from three sources: the middle cerebral artery, anterior cerebral artery, and posterior cerebral arteries.

The risk factors for a parietal lobe stroke are no different than those for other types of stroke. They include:

• High blood pressure
• Obesity
• High cholesterol
• Diabetes
• Cigarette smoking
• Lack of physical exercise
• Heavy alcohol use
• Processed red meat consumption
• Previous transient ischemic attack (TIA)
• Family history of stroke

How Is a Parietal Lobe Stroke Diagnosed?

Things can move quickly when a stroke is suspected. In some cases, the symptoms will be overt, and you may be rushed for emergency imaging tests and other urgent evaluations. In other cases, the symptoms may be less characteristic and require a combination of tests to determine the cause.

Neurological Exam

If stroke is suspected, the healthcare provider will typically perform an in-office neurological exam. The test evaluates your motor, cognitive, and visual responses to various stimuli to see if there are any abnormalities suggestive of a stroke.

The neurological exam is painless and can be performed with simple tools, including a penlight and a reflex hammer.

Diagnostic signs suggestive of a parietal lobe stroke include:

• Problems stringing together words or syllables
• Behaving as if the left side of a space is nonexistent
• Loss of vision in the same lower quadrant of both eyes
• Difficulty writing or writing with excessive force
• Poor postural control, including the stomping of feet

Tests and Labs

Other tests will be ordered to confirm the diagnosis and characterize the type of stroke involved. These may include:

• Blood tests to check for infection, abnormal blood sugar, and the rate of blood clotting
• Imaging studies, including a computed tomography (CT) or magnetic resonance imaging (MRI) scan, to locate and determine the cause and extent of the blood flow obstruction
• Carotid ultrasound, which uses sound waves to locate fatty deposits (plaques) in the carotid artery of the neck
• Echocardiogram, which also uses sound waves to establish where in the heart a plaque may have broken off and traveled to the brain

What Is the Treatment of a Parietal Lobe Stroke?

Catching a stroke early is the most effective form of treatment. The first course of action in an emergency is to restore blood flow to the brain and/or limit any damage caused by the sudden lack of oxygenated blood.

Depending on the type of stroke involved, a blood thinner called tissue plasminogen activator (TPA) may be given to improve blood flow to the brain. Another blood thinner called heparin may be used in cases of ischemic stroke if a brain hemorrhage has been ruled out.

Blood pressure, blood glucose, fluids, and electrolytes will also be managed to give the brain the best chance for recovery.

Surgery

If an ischemic stroke in the cerebral cortex (known as a cortical stroke) is accompanied by severe edema (swelling of the brain), a surgery known as craniotomy may be performed to relieve the pressure and reduce the risk of brain damage. It involves the temporary removal of a portion of the skull until the swelling in the brain subsides.

If there is a severe hemorrhagic stroke, a hematoma evacuation may be performed to surgically extract the pooling of blood in the brain (called a hematoma).

Rehabilitation and Recovery

In the aftermath of a stroke, most people will undergo physical therapy and occupational therapy to help restore function and learn adaptive strategies to perform everyday tasks.

Given that impaired speech and language are common consequences of a parietal lobe stroke, intensive, ongoing speech therapy may be advised.

Studies suggest that at least 90 hours of speech therapy may be needed to overcome aphasia and other speech pathologies; anything less than 45 hours may not be beneficial.

Coping and What to Expect After a Stroke

Anger, sadness, anxiety, and depression are all common responses to a stroke. With a parietal lobe stroke, these emotions can be amplified given the disorienting nature of the symptoms. The impairment of communication compounded by the loss of spatial orientation can make it difficult to interact with others or cope with the rigors of daily life.

As part of the rehabilitation efforts, a mental health professional may be sought to address the psychological and psychiatric concerns alongside the physical ones.

Treatment may involve one-on-one or group counseling to better deal with grief, anger, and self-esteem issues, as well as any changes in personality or behavior. Support groups and family counseling can also be extremely beneficial.

Fatigue, a common and distressing facet of stroke recovery, tends to improve with a combination of psychotherapy and graded exercise (in which exercise intensity and duration are gradually increased).

Antidepressants or central nervous system stimulants like Vyvanse (lisdexamfetamine) or Adderall (amphetamine/dextroamphetamine) may also be used to boost mood and energy levels.

It can also be challenging to be a caregiver of someone who has had a parietal lobe stroke. The loved one may not only need constant monitoring to avoid falls and other injuries, but they may also be less aware of their surroundings and unable to fully participate in their rehabilitation.

To get through this difficult time, it is important to seek as much support from healthcare professionals, family, and support groups. Support services for those affected by a stroke or their caregivers can be found using the online locator operated by the American Stroke Association.

Summary

A parietal lobe stroke affects the part of the brain responsible for spatial awareness and language processing. A stroke in this part of the brain can cause problems with speech and language, difficulty with proprioception, a loss of spatial awareness, impairment of executive functioning, and visual disturbances.

The treatment of a parietal lobe stroke typically involves blood thinners to avoid further brain damage and possibly surgery to relieve pressure on the brain or stem cerebral bleeding. Recovery from a stroke almost invariably involves physical, occupational, and speech therapy.