PICTURE THIS: What a stroke can do to your handwriting

These odd shapes are a stroke patient’s first attempt at writing after his debilitating attack.

The 74-year-old man, from the U.s., had suffered a haemorrhagic stroke one month previously.

Although not as common as ischaemic strokes (caused by a blockage in a vessel supplying the brain), haemorrhagic strokes — due to bleeding in or around the brain — can be more serious.

The image here was posted on Figure 1, an app and website where doctors around the world share medical images and canvass their colleagues’ opinions.

The speech and language therapist who posted this explains the patient was suffering from various physical difficulties following his stroke, which affected the Broca’s area on the left side of the brain.

This plays a crucial role in speech, language and our ability to put thoughts into words, so can be badly affected by a stroke of this kind.

‘ specifically, this may be choosing the wrong word, putting words together incorrectly or pronouncing things incorrectly,’ says Professor Graham stokes, global director of dementia care at Bupa, who was previously a senior consultant clinical psychologist in the Nhs for 25 years.

And if a stroke occurs in the socalled ‘language hemisphere’, as it has here, it can affect our ability to communicate in writing, too — sometimes permanently if the brain cells have been starved of their blood supply and oxygen and have died.

The symbols in the image above are what the patient managed to produce after being asked to write down the words ‘ boat’ and ‘song’.

‘The left side of brain controls the right side of the body, and vice versa,’ says Professor stokes. ‘Therefore, if we assume this man is right-handed, as most people are, it would explain the difficulty he now has with writing.

‘This image suggests he is also suffering from dysgraphia — a neurological disability common in people with aphasia, caused by the stroke. That leads to a person’s writing being distorted or incorrect,’ he adds.

‘ With dysgraphia, it may become difficult to recall the spelling of words, or how to put words in the correct order to make sentences. In some cases, it is even challenging to remember how to form the letters that make up words.

‘This patient can write in as far as he can hold a pen and use it, but he has problems in the planning and production of the correct sequence of movements, which is why the writing has ended up as shapes.

‘Basically, he cannot generate the movements required to write them — it is a severe example.’

The good news is that the patient made great progress. After practising on his own at least 100 times, he was finally able to write his name unaided.

‘stroke patients can improve with training and effort as the brain can “re-wire” itself around the damage,’ says Professor stokes. ‘however, training needs to start as soon as possible after the attack.’