Each hemisphere of the cerebrum (the largest portion of the brain) is made up of 4 lobes: frontal, parietal, occipital, and temporal. As I think about patients who suffered traumatic brain injury, I see how the location of their injury affects their ability to function.

Wilma (fictitious name) suffered a frontal lobe injury when she was thrown into the windshield after her car was rear-ended. Wilma got lost driving in her neighborhood, could not figure out how to operate her security alarm on her house, or to how to assemble food in the right order to follow a recipe.

The frontal lobe is behind the forehead. It controls emotion, personality, judgment, morality, language, problem solving, and impulse control.

Problems in this area of the brain may result in the following:

• Recent memory deficits.
• Inattentiveness.
• Poor concentration.
• Behavioral disorders/personality changes.
• Inappropriate social and/or sexual behaviors.
• Flat affect.
• Depression.
• Expressive aphasia (the person knows what they want to say but has difficulty with communicating the words or sentences).
• Impulsiveness.
• Psychotic disorders (abnormal thinking and perceptions; difficulty staying in touch with reality).

Roger was hit on the top of the head by an object that fell off a shelf in a store. He suffered a parietal lobe injury. The parietal lobe is under the top and back half of the skull. Roger had difficulty walking because he could not tell where his feet were in relationship to the floor. He also had trouble following conversations. The parietal lobe affects sensory function, pain, temperature, spatial relations, and proprioception (sense of body position).

Problems in this lobe can cause deficits in:

• Ability to read, draw, or write.
• Receptive aphasia – difficulty understanding others.
• Problems with perception or awareness of one side of the body.
• Ideational apraxia – the loss of the ability to carry out purposeful movements.
• Constructional apraxia – the loss of the ability to copy objects.
• Dressing apraxia – the loss of the ability to know how to dress.

Gretta had a seizure disorder. She fell backward during a seizure and struck the back of her head. She became blind. The occipital lobe in the back of the head affects vision. Injuries to the occipital lobe may cause deficits in:

• Receiving visual input.
• Visual interpretation.
• May cause blindness.

Juan was hit in the side of the head by a baseball bat. He had a temporal lobe injury. He lost his memory of recent as well as distant events and had a severe speech impairment. The temporal lobe is the major area for memory and affects hearing, language reception, and the sense of smell and taste. Deficits in this area can cause:

• Hearing problems.
• Agitation.
• Irritability.
• Receptive aphasia (difficulty understanding others).
• Attention deficits.

By understanding the locations of the functions of the brain, it is possible to understand how injuries to these areas result in deficits.

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