Can you have post stroke symptoms even years afterwards?

A fellow caregiver asked...

After suffering a massive stroke, can a stroke survivor have side affects down the road, 6+ years later? The symptoms that have recently appeared are anger (false accusations towards the caregiver), withdrawal,thoughts of death and being consumed with sex. His mother and grandmother both died of Alzheimer's, could this be the start? He was 54 when he had his stroke and he is now 60.

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

The general rule of thumb regarding stroke symptoms is that they improve slowly over time. Any new symptoms should prompt a workup for another disease.

It sounds to me like the person in question here has a neurodegenerative disorder - such as Alzheimer's Disease, Fronto-Temporal Dementia, Lewy Body Dementia or others. The stroke likely made this worse, by severely damaging the normal reserve brain capacity. Most people are able to cope with some neuro-degeneration, such that their symptoms do not appear until later years. However, if a major damaging event has already compromised their brain function, the symptoms of their neuro-degenerative disease may become evident sooner than expected.

I recommend bringing this person to a Neurologist, or specifically to a Cognitive Specialist (a subspecialty of Neurology) for further evaluation and treatment.