Consequences of an AVM hemorrhage

Cognition (invisible consequences) after a cerebral hemorrhage

Other people are most likely to notice the physical limitations of a cerebral hemorrhage. The “invisible” consequences are often less noticeable and often only become evident at a later stage.

• Fatigue

  A lot of people experience (severe) fatigue after a cerebral hemorrhage. This is common and prolonged. The cause of this fatigue is not always clear. Researchers think that the fatigue is a direct consequence of the damage in the brain itself, but it may also be related to physical and mental exertion. Things that used to be easy now cost a lot of effort and energy. Fatigue affects your physical, emotional and mental functioning.

• Memory

  In general, people who have suffered a cerebral hemorrhage can remember things from long ago, but they are unable (or struggle) to remember new information. Fatigue and reduced attention and concentration can play an important role in this. If you experience this, then this can also have a negative effect on your memory.

• Attention and concentration problems

  Problems with attention and concentration are common after a cerebral hemorrhage and can decrease or even disappear over time. Attention and concentration problems can be expressed in various ways. Someone might struggle to concentrate, for example, when trying to follow a conversation, read a book or watch a movie. Or someone can become distracted more easily by stimuli in the environment, such as a radio or conversations of other people. This often makes it more difficult to do several things simultaneously, such as driving a car and chatting to the passenger at the same time, or cooking and talking.
  A lot of people notice their thought process slowing down and the information in their surroundings going much too fast. Following a cerebral hemorrhage, it takes much more effort to follow a conversation or TV program. Activities that involve a lot of people, such as a birthday party, are also tricky for many people. They feel that the information passes too quickly for them to follow and process it. This is called delayed information processing or a delayed thinking speed. This can also become apparent in activities that require quick actions, such as in traffic, sports or certain fast activities at work.

• Reduced flexibility

  Some people are not as flexible as they used to be after a cerebral hemorrhage. This can become apparent, for example, in struggling to think of a different solution to a problem when they encounter one. Or they struggle to implement a different plan if something does not go as they had planned or thought out.

• Perception

  Everyone recognizes errors that we sometimes make in spatial perception: estimating a distance incorrectly, meaning that we place the cup next to the table instead of on the table. Or we think that there is another tread on the stairs when we are already downstairs. A cerebral hemorrhage patient who has suffered damage to the right side of the brain will often experience these types of situations. He or she confuses left and right, or cannot accurately estimate the distance to a certain object. This can affect actions that require good spatial planning, such as getting dressed.

• Planning and organization

  Following a cerebral hemorrhage, some people are no longer able to plan and organize their lives. This can affect their ability to organize their day, household chores and work. As a result, this person might not be able to maintain an oversight when performing complex tasks, such as preparing a meal. Sometimes they are no longer able to plan in advance which items then need for an activity. For example, they will walk to the bathroom without taking the items they need to have a shower.

Changes in emotions and behavior

Some patients with a cerebral hemorrhage respond differently to events (including emotional events) immediately after the stroke than before. Their reactions are more intense, because they have less control over their emotions and sometimes they are unable to tolerate stimuli in their surroundings, making them more irritable.
Some people respond more impulsively, aggressively or they may swear, whilst they would never have done this before. Others become more passive, lacking in initiative and more negative than previously. Others become emotional more quickly and will laugh or cry more quickly than normal. Some people will also be more selfish after a cerebral hemorrhage and those around them will see them as being more self-centered. They pay less attention to their surroundings or their partner. The loss of independence, self-reliance and not being considered a complete person can also cause frustration, outbursts of anger and feelings of helplessness and depression. Some people say: “It is as if my partner/father developed a different personality than he used to have”.
All these reactions are the result of damage in the brain and/or the fact that their life has been turned upside down.