Communication difficulties following right hemisphere stroke: applying evidence to clinical management

Following reports in the 1960s that language may be affected by right-hemisphere (RH) lesions, many limitations to effective communication in the population with right-hemisphere damage (RHD) have been described. However, stereotypical portrayals and descriptions of carefully selected cases may be misleading as to the extent of communication deficits. In many of the parameters in which RHD patients are presented as typically impaired (e.g. discourse skills), a less severe picture may emerge when data from the non-brain-damaged (NBD) population are considered, controlling for age and education-level variables. Subsequent to RHD, some people show deficits on some communication measures, but many of these communication behaviours are also present in some NBD adults. Thus, diagnosis of deficit must be made with reference both to the healthy peer population and the individual's pre-lesion behaviour.