Any brain function can be disrupted by brain trauma: excessive sleepiness, inattention, difficulty concentrating, impaired memory, faulty judgment, depression, irritability, emotional outbursts, disturbed sleep, diminished libido, difficulty switching between two tasks, and slowed thinking.
Sorting out bonafide brain damage from the effects of migraine headaches, pain elsewhere in the body, medications, depression, preoccupation with financial loss, job status, loss of status in the community, loss of status in the family, and any ongoing litigation can be a formidable task.
The extent and the severity of cognitive neurologic dysfunction can be measured with the aid of neuropsychological testing. Neuropsychologists use their tests to localize and identify dysfunction to specific areas of the brain. For example, the frontal lobes play an essential role in drive, mood, personality, judgment, interpersonal behavior, attention, foresight and inhibition of inappropriate behavior. The ability to plan properly and execute those plans is known as “executive function.”
Frontal lobe injury is often associated with damage to the olfactory bulbs beneath the frontal lobes. Survivors may note a reduced, or altered sense of smell. One recent study (Varney 1993), showed that 92% of survivors of brain injury suffering anosmia (loss of smell) had ongoing problems with employment, even though their neuropsychological testing was relatively normal.
The effects of brain injury on the survivor may be equaled, or even surpassed, by the effect on the family. Brain injuries are known for causing extreme stress in family and interpersonal relationships. In general, the symptoms should lessen over time as the brain heals, but may worsen because of the survivor’s inability to accept help, or adapt to the brain injury. For this, and other reasons, it is not uncommon for psychological problems to surface, and worsen after brain injury.
Symptoms vary widely after “brain injury”, and the nature of them depends, in large part, on where the brain is injured. Below is a list of possible physical and cognitive symptoms which may arise from damage to specific areas of the brain:
FRONTAL LOBE: forehead
- Loss of simple movement of various body parts (Paralysis).
- Inability to plan a sequence of complex movements needed to
complete multi-stepped tasks, such as making coffee (Sequencing).
- Loss of spontaneity in interacting with others.
- Loss of flexibility in thinking (Rigid Thinking).
- Persistence of a single thought (Perseveration).
- Inability to focus on task (Attending).
- Mood changes (Emotionally Labile).
- Changes in social behavior.
- Changes in personality.
- Difficulty with problem solving.
- Inability to express language (Broca’s Aphasia).
- Difficulty with serial tasking.
PARIETAL LOBE: near the back and top of the head
- Inability to attend to more than one object at a time.
- Inability to name an object (Anomia).
- Inability to locate the words for writing (Agraphia).
- Problems with reading (Alexia).
- Difficulty with drawing objects.
- Difficulty in distinguishing left from right.
- Difficulty with doing mathematics (Dyscalculia).
- Lack of awareness of certain body parts and/or
surrounding space (Apraxia) that leads to difficulties in self-care.
- Inability to focus visual attention.
- Difficulties with eye and hand coordination.
OCCIPITAL LOBES: most posterior, at the back of the head
- Defects in vision (Visual Field Cuts).
- Difficulty with locating objects in environment.
- Difficulty with identifying colors (Color Agnosia).
- Production of hallucinations.
- Visual illusions – inaccurately seeing objects.
- Word blindness – inability to recognize words.
- Difficulty in recognizing drawn objects.
- Inability to recognize the movement of object (Movement Agnosia).
- Difficulties with reading and writing.
- Reduced peripheral vision.
TEMPORAL LOBES: side of head above ears
- Difficulty in recognizing faces (Prosopagnosia).
- Difficulty in understanding spoken words (Wernicke’s Aphasia).
- Disturbance with selective attention to what we see and hear.
- Difficulty with identification of, and verbalization about objects.
- Short term memory loss.
- Interference with long term memory.
- Increased and decreased interest in sexual behavior.
- Inability to catagorize objects (Categorization).
- Right lobe damage can cause persistent talking.
- Increased aggressive behavior.
- Ringing in the ear (Tinnitus).
BRAIN STEM: deep within the brain
- Decreased vital capacity in breathing, important for speech.
- Swallowing food and water (Dysphagia).
- Difficulty with organization/perception of the environment.
- Problems with balance and movement.
- Dizziness and nausea (Vertigo).
- Sleeping difficulties (Insomnia, sleep apnea).
CEREBELLUM: base of the skull
- Loss of ability to coordinate fine movements.
- Loss of ability to walk.
- Inability to reach out and grab objects.
- Dizziness (Vertigo).
- Slurred Speech (Scanning Speech).