Comparison of Stroke Sequelae: Differences in Paralysis Severity, Cognitive Impairment, and Return-to-Work Rates, and the Symptoms Patients Find Most Distressing

After surviving the acute treatment phase of a stroke, patients and their families face the battle against residual deficits (sequelae). The type and severity of these deficits vary significantly depending on the stroke type—Ischemic Stroke (Infarction), Intracerebral Hemorrhage, or Subarachnoid Hemorrhage—and the recovery processes are distinct for each.

Differences in Sequelae Across the Three Types of Stroke

FeatureIschemic Stroke (Cerebral Infarction)Intracerebral HemorrhageSubarachnoid Hemorrhage (SAH)
Probability of Residual SequelaeApprox. 50–70%Approx. 70–80%Approx. 40–60% (among survivors)
Most Common SequelaHemiparesis (Paralysis of one side)Hemiparesis + Higher Brain DysfunctionMemory Impairment, Concentration Deficits, Personality Change
Severity of ParalysisHighly variable, from mild to very severe.Less likely to have severe paralysis (often mild if present).Less likely to have severe paralysis (often mild if present).
Difficulty Speaking (Aphasia)◎ Very common (especially with Left Hemisphere stroke)◯ Moderately common△ Infrequent
Risk of DementiaHigh probability if Lacunar Infarction recurs.Quite high.Can affect even young people (especially if bleeding near the frontal lobe).
Personality ChangeRarely changes significantly in mild cases.Prone to anger/emotional incontinence.Many experience significant changes (e.g., zero motivation).
Risk of Depression◯ Moderately common◎ Very common◎ Over half of survivors
Epilepsy (Seizures)Approx. 5–10%Approx. 20–30%Approx. 10–20%
Probability of Walking RecoveryApprox. 60–80% (Over 90% if Thrombectomy is possible).Approx. 30–50%Approx. 80–90%
Probability of Returning to Work50–70% in mild cases.20–40%50–70% (But “same as before” is often difficult).
Most Distressing Sequela (Patient’s Voice)“My hand won’t move, and I have no sensation.”“Half my body is paralyzed + my head is constantly fuzzy.”“My body works, but my mind is not my former self… (fatigue, lack of drive).”
Biggest Factor for Mild SequelaeThe shorter the time from onset to treatment, the more dramatic the improvement!Less bleeding volume + Rapid BP reduction.Successful prevention of re-bleeding and vasospasm.

Summary (Common Patient Statements)

  • Ischemic Stroke → “My limbs don’t move, but my mind is clear.”
  • Intracerebral Hemorrhage → “Half my body is paralyzed, and my mind is constantly clouded.”
  • Subarachnoid Hemorrhage → “My body moves, but my mind isn’t the person I used to be…”

Recently, Ischemic Stroke sequelae have become the mildest (thanks to Thrombectomy, “miraculous recovery” is genuinely increasing!).