Is swelling in one limb normal after a stroke?

1 answer | Last updated: Oct 23, 2016
A fellow caregiver asked...

My father had a brain hemorrhage 3 months ago and he is now walking again with a walker. In the weak left leg caused by the stroke he has always had some swelling down the leg and ankle and tightness. The left leg is always a little pinker in color than the other leg which is his normal leg. Can you tell us how to reduce this swelling and if it is a problem that should be looked into by x-ray or some other method. Thanks for the help, it is much appreciated. Sandra

Expert Answers

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

I see this quite frequently after a stroke. The first thing to do is make sure that he does not have a clot in one of the veins of the leg. A clot in the veins can occur in a stroke victim because they are not moving the leg as much as a healthy person, and thereby the blood is not flowing properly. This can be very easily evaluated by an ultrasound of the leg - please check with your doctor on getting that test.

If he does not have a clot, as is most often the case, then I usually start with simple tricks like keeping the leg elevated, particularly at night, to allow the fluid to slowly leave. Another trick is to have him wear a tight fitting sock that runs up the leg to help keep the fluid out. Jobst Stockings are sold at most pharmacies, and are often helpful for this purpose if he doesn't find the stocking uncomfortable.

The cause of the swelling is a lack of good neural control of the vessels in the leg, making them leaky, and prone to allowing fluid to build up in the soft tissues. Typically, the methods above are very helpful, but every once in a while a diuretic medication (such as Lasix) is needed. Keep in mind, as long as the ultrasound shows no vein clot, this is typically a benign issue, and it may not be worth the risk of starting a medication if he is not too bothered by the swelling.

Good luck!