Brain functions by injury to specific location

Posted by Nurse Linda in Life After Paralysis on March 11, 2019 # Health

BrainThe brain is quite a complex body organ. It is a part of the central nervous system which includes the brain and the spinal cord. When the spinal cord is affected due to disease or trauma, functional difficulties might appear. The resulting effects on the body depend on the location of injury to the spinal cord. In the brain, the location of the injury will affect how the body works and how thinking occurs.

Brain injury is a common partner to spinal cord injury. Even though an injury to the brain can affect just that one spot, the brain is intertwined in its functioning. An injury to one part can affect other parts of the brain and the entire nervous system.

There are basically six parts of the brain. Each part contains important structures. This information is a very general overview of the basic functions of the parts. Neuropsychological testing can isolate specific areas of the brain that are affected by injury thereby tailoring a specific treatment plan.

Frontal Lobes
The frontal lobes of the brain are located just as they are titled, right up in the front of the skull behind the forehead. They extend about halfway toward the back of the head and down the side of the head to about the level of your eyebrows. There are two lobes that sit next to each other, the left and the right side.

This part of the brain is often called the mother because it governs your actions just as your mother would stop impulsive or antisocial actions. The frontal lobe is responsible for emotional, social and sexual control, attention, motivation, judgment, spontaneity, problem-solving, and sequencing. It also handles verbal expression, motor integration, voluntary movement, and sequencing.

Personality changes can occur with frontal lobe injury. These can be brief or long-lasting. Medications can be prescribed if behavior becomes aggressive or threatening.

Injury to one or both frontal lobes is often seen as difficulties in social and behavioral situations. All therapies and nursing are included in treatments for frontal lobe injury. Treatments include reeducation about reactions to situations which might be practiced before entering the real situation. For instance, in a therapeutic session, the patient may be presented with pictures or enactment of a situation followed by the patient responding. The individual is then guided to an appropriate response if needed.

Other therapies might include practice in ordering activities such as putting socks on before shoes if that is an issue for the individual. Choices can be encouraged when the individual is recovered enough to do so.

It is important to follow the instructions of your healthcare professionals when providing care for the individual with a frontal lobe injury. They are in the best position to indicate which techniques should be used and when to advance options. Your input about how you are feeling and responding to therapy should be considered. Pushing too hard or too fast can increase frustration.

Temporal Lobes
The temporal lobes are on both sides of the brain. They are located approximately above the ear. On the outside of your body, the temporal lobes are at the temples of your head. They extend back behind the ear.

The temporal lobes control selective attention to what is seen or heard, short term memory, understanding language, music, locating objects, categorizing, face recognition, aggressive behavior, and altered sexual behavior. Individuals with temporal lobe injury might have issues with memory and understanding. Results of temporal lobe injury can be different if the injury is only on the left or right side of the brain.

Treatment for temporal lobe injury focuses on comprehension and communication. Traditionally, a speech and language pathologist might be responsible for treatment however, all members of the healthcare team will incorporate strategies into their plan. This includes input from the individual with the temporal lobe injury and their family. It is important to relate your thoughts and feelings, so therapy can be tailored to your specific needs.

Parietal Lobes
The parietal lobes are at the back top of the brain. They are located directly behind the frontal lobes, above the temporal and occipital lobes.

The responsibility of the parietal lobes includes coordination, touch, body positioning in space, awareness of body differentiation, academic skills, naming objects, right vs. left, and visual attention. The parietal lobe is a main connector for different parts of the brain either sending messages for interpretation or making those interpretations.

Individuals with parietal lobe damage may have difficulty in recognizing or acknowledging both sides of their bodies. They may have problems with coordination. Higher level thinking may be at risk such as handling money or complex planning. New learning might be a challenge.

Treatment for parietal lobe injury includes reminders to look at both sides of the body, estimating space needed for your body to pass through doors and hallways, academic work and other higher-level challenges. Therapists and nurses will create situations for the individual to learn how to function in the world such as making a list for groceries, finding the items in the store, and making the correct payment.

Occipital Lobes
The occipital lobes sit at the very back, bottom of the brain. On the outside of the body, they would be just above the base of the back of the skull. Their main job is vision and reading.

If you have heard the expression: seeing stars, this is what happens when the occipital lobe is injured. When pressure is applied to the occipital lobes, a sudden burst of energy appears to the person like pinpoints of light in the visual field.

An injury to the occipital lobes can lead to visual field cuts, difficulty seeing objects or colors, hallucinations, blindness, inability to recognize written words, reading or writing, inability to see objects moving, and poor processing of visual information.

One of the most important concepts in treating occipital lobe injury is to help the individual realize the results of the injury. Typically, the individual does not know that they are not seeing correctly because their brain does not recognize the visual disturbance. For example, they might have a visual field cut or an inability to see to the right or left but they will not realize that they are not seeing that part of the world. They might not even realize that part of the world exists depending on the severity of the injury.

Treatment for occipital lobe injury must be incorporated by the entire healthcare team including the individual patient. Reminders to scan the environment will help the individual to see the other side of their dinner plate, room, or world. If reading, the written material might not make sense because half of the sentence is not seen. Scanning can help but can be frustrating with every line. Audiobooks can help to cue the reader while looking at the written word. This can be fatiguing so short sessions should be used. Special eyeglasses might be prescribed to assist with visual deficits.

The Cerebellum
The cerebellum is tucked under the occipital and temporal lobes. It is well protected anatomically but that does not mean it cannot be injured. It has a high risk of injury when a brain injury occurs.

The cerebellum is responsible for coordination of voluntary movement, gross and fine motor control, balance and equilibrium, and eye movement. Injury to the cerebellum can lead to standing problems, slurred speech, and incoordination. Falling is a real issue with cerebellar injury due to balance, coordination, and visual issues.

Physical and occupational therapy and nursing can benefit the individual with a cerebellar injury. This would include strengthening and balance exercises. Adaptive equipment to ensure safety when mobile is a must to avoid injury from falls. Learning to move slowly and cautiously is necessary.

The Brain Stem
The brain stem is at the top of the spinal cord. It is the connection between the brain and the spinal cord. It is located at the underside center of the brain, almost at the center of the inside of the head. This is a well-protected area of the body, however stretching, pulling or swelling around the brain stem can lead to injury.

The brain stem houses a lot of the functions of the autonomic nervous system, a system with which individuals with spinal cord injury are well familiar. It is where heart rate, breathing, temperature, alertness, sleep, and all automatic functions of the body pass through. It has control of balance, movement, and swallowing.

Injury to the brain stem can lead to issues with walking or even sitting as balance is affected. Eating and hydration can be altered because of difficulty in swallowing food and fluids. Dizziness can lead to nausea and vomiting. Wake/sleep cycles can be altered. All of the autonomic systems can be disrupted as with spinal cord injury.

A brain stem injury might not be noticed right away after an injury. Careful monitoring of an individual needs to occur to ensure basic body functions are activating. This can include breathing which can slow over time due to swelling in the brain stem area. There are many life-sustaining treatments that can assist a person with a brain stem injury. Mechanical ventilation, mobility equipment, and feeding tubes are just a few. More advanced, long-term treatments are also in use such a phrenic nerve stimulation. The objective of treatment of a brain stem injury is to maintain vital functions while continuing with rehabilitation.

As you can see, the brain is a complicated and delicate organ of the body. The parts of the brain work together for function. Many parts of the brain overlap in functions or interpretation of function. Brain injury can range from mild to extensive. Recovery of a brain injury can be very slow. Some effects might be life-long. Learning to adapt to these issues is key. Be sure to ask what activities you can do on your own to continue your progress. You and your family must be active participants in brain injury recovery.

Pediatric Consideration
The brain works in the same way for children as for adults. Additional therapies are needed at an age-appropriate level to match growth and development. Follow up is critical as the child is challenged with more complex tasks. For example, a three-year-old would start counting but a teen needs to use numbers for money management. In addition to your family, the teacher can help provide insight into your child’s learning abilities.

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The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.