The brain. It generally takes up 2% of our body weight and weighs about 1.4kg (Farrell & Dempsey 2013).

It is who we are and although we all have one, it is the one thing that makes us unique.

So, it makes sense that when damage occurs to the brain, changes also occur to the person. These changes vary considerably and could include alterations to the person’s speech, their mobility, their memory and even their personality.

Our brains can become damaged in many ways: maybe from a stroke, a tumour, or a knock to the head. And, any symptoms that the person displays is all dependent on where their brain was damaged and the extent of the damage.

Generally brain damage is described depending on location of the injury, so it may be which lobe the site of the injury is located at or which vessel has been damaged, for example: a glioblastoma in the left parietal lobe or a middle cerebral artery (MCA) stroke. 

Frontal Lobe

When people think of the frontal lobe, they think of it as the lobe that makes us who we are and gives us our personality.

It is also the lobe that gives us our concentration, memory, affect, judgment, inhibitions, abstract thought and motor function, including our motor control of speech. It is also important to note that it is where Broca’s area for language production is located (Farrell & Dempsey 2013; Mauk 2012).

Damage to our frontal lobe can result in:

• Inability to express language (Broca’s aphasia)
• Motor weakness, usually loss of simple movements of various body parts
• Personality and behavioral changes
• Inability to plan a sequence of complex movements
• Inability to focus on a task
• Difficulty with problem solving
• Difficulty when interacting with others; and
• Mood changes.

(Kowalak & Hughes 2002; Lehr 2017)

Parietal Lobe

The parietal lobe assists in the coordination of all our sensory information that is coming into our brain and is where our sensory information is analyzed and interpreted.

The parietal lobe is also the area in which we have our centre for memory so we are able to identify objects. And, as if it doesn’t do enough already, it is also an important area that allows us to have spatial awareness (Farrell & Dempsey 2013; Mauk 2012).

Damage to our parietal lobe can result in:

• Inability to name an object (Anomia) or locate a word to write down (Agraphia)
• Difficulties with reading and drawing objects
• Difficulty with differentiating between left and right
• Difficulty with mathematics
• Loss of spatial awareness and awareness of certain body parts, which can make it difficult with self caring tasks
• Difficulties with hand and eye coordination; and
• Visual field deficits.

(Kowalak & Hughes 2002; Lehr 2017)

Occipital Lobe

The name of this lobe says it all; the occipital lobe is primarily responsible for our visual interpretations and is where our signals from the retina are perceived (Farrell & Dempsey 2013).

Damage to our occipital lobe can result in:

• Inability to name objects (Visual agnosia)
• Visual field deficits
• Difficulty with locating objects in their visual field
• Visual hallucinations
• Word blindness (the inability to recognise words); and
• Difficulties with reading, writing, recognising objects and distinguishing colours.

(Kowalak & Hughes 2002; Lehr 2017)

Temporal Lobe

The temporal lobe not only contains our auditory receptive areas but is also an interpretive area for the integration of the visual, auditory and somatic information our brain is receiving.

It also holds a very important area for us that allows us to understand words, speech and language, called Wernicke’s area (Farrell & Dempsey 2013; Mauk 2012).

Damage to our temporal lobe can result in:

• Auditory hallucinations
• Difficulty in recognising faces (Prosopagnosia)
• Difficult in understanding spoken words (Wernicke’s aphasia)
• Short term memory loss
• Personality changes including increased aggressive behaviour; and
• Difficulty with identifying and verbalising seen objects.

 (Kowalak & Hughes 2002; Lehr 2017)

Thalamus and Hypothalamus

The thalamus is important for maintaining our level of alertness, and is also where all of our sensations (except smell), pain impulses, sensation and memory pass through. (Farrell & Dempsey 2013; Mauk 2012).

The hypothalamus is an area that has many functions: it assists with the regulation of hormones, helps maintain fluid balance, controls the sleep-wake cycle, regulates blood pressure, controls emotional responses, maintains temperature regulation, and controls and regulates the autonomic nervous system (Farrell & Dempsey 2013).

 Damage to the hypothalamus can result in:

• Diabetes insipidus; and
• Temperature control loss.

(Kowalak & Hughes 2002)

Pons

The pons, along with the midbrain and medulla oblongata, make up our brain stem, which control our most primitive functions and is what keeps us alive.

The pons controls our heart, respiration and blood pressure. Additionally, it contains some motor and sensory pathways (Farrell & Dempsey 2013).

Damage to the pons can result in:

• Facial sensation loss
• Corneal reflex loss
• Facial muscle drooping
• Inability to gaze outwards; and
• Corneal reflex loss.

(Kowalak & Hughes 2002)

Midbrain

The midbrain is our centre for auditory and visual reflexes and also contains sensory and motor pathways (Farrell & Dempsey 2013).

Damage to the midbrain can result in:

• Ptosis (drooping of the upper eyelid)
• Diplopia (double vision)
• Dilated pupils; and
• Inability to gaze up, down or inward.

(Kowalak & Hughes 2002)

Medulla Oblongata

The medulla oblongata connects our brain and our spinal cord with most of our sensory and motor fibres either crossing into the brain or finishing at this level (Farrell & Dempsey 2013).

Damage to the medulla oblongata can result in:

• Difficulty swallowing
• Loss of gag and cough reflex
• Vomiting
• Tongue protrusion; and
• Respiratory pattern changes.

(Kowalak & Hughes 2002)

Cerebellum

Our cerebellum is responsible for our coordination of movement and controls our balance, posture, muscle tone and awareness of each part of our body. It is also an area for some of our cognitive functions such as attention, language and emotion, and furthermore helps to integrate some of our sensory input (Farrell & Dempsey 2013; Mauk 2012).

Damage to the cerebellum can result in:

• Disturbed gait and inability to walk
• Impaired balance
• Incoordination
• Inability to reach out and grab objects
• Dizziness and vertigo
• Slurred speech; and
• Inability to make rapid movements.

(Kowalak & Hughes 2002; Lehr 2017)

As you know, our brain controls who we are, what we do and how we do it. Everyone’s brains are different and because of this, damage to one area of the brain will show certain symptoms in one person but may not be the exact same to the next person.

It is also important to note that for some brain injuries, there will also be secondary injuries occurring as well as a result from the swelling and homeostatic response to the initial injury (Mauk 2012). Caring for someone following a brain injury will be dependent on the injury and their subsequent deficits, and often involves rehabilitation from a multidisciplinary team.

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References

• Farrell, M & Dempsey, J (eds) 2013, Smeltzer & Bare’s Textbook of Medical-Surgical Nursing, 3^rd edn, Lippincott, Williams & Wilkins, Broadway.
• Kowalak, JP & Hughes, AS 2002, Atlas of Pathophysiology, Springhouse, Pennsylvania.
• Lehr, RP 2017, Brain Function, Center for Neurological Skills, viewed 20 March 2017, http://www.neuroskills.com/brain-injury/brain-function.php
• Mauk, KL 2012, Rehabilitation Nursing: A contemporary approach to practice, Jones & Bartlett Learning, Sudbury.

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