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Right Hemisphere Brain Damage

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Damage to the right hemisphere of the brain can lead to cognitive-communication problems, such as impaired memory, attention problems and poor reasoning. In many cases, the individual with right brain damage is not aware of the cognitive difficulties or communication problems that they are experiencing.

Causes

The causes of right hemisphere damage include:

Stroke
Traumatic Brain Injury
Surgery
Infection/Illness
Tumor

Characteristics

People with right hemisphere damage experience communication problems that are more subtle in nature than those that occur from left hemisphere damage. This is due in part to the fact that, in most of the population, the language centers are in the left hemisphere, while cognitive functioning is often housed in the right hemisphere. Cognitive-communication problems that can occur from right hemisphere damage include difficulty with:

Attention
Memory
Organization
Reasoning
Problem-solving
Orientation
Left-side neglect
Social judgment/pragmatics

Attention problems from right hemisphere damage include difficulty concentrating on a task amid distractions and paying attention for more than a few minutes at a time. Also, performing more than one task at once may be difficult or impossible.

A person's memory may be affected, as well. They may have difficulty recalling already learned information, such as street names or important dates, and may not be able to learn new information easily.

Organization problems include being able to correctly sequence events when telling a story or giving directions or maintaining a topic while conversing with others. Reasoning may also be impaired and the person may not be able to interpret abstract language, such as metaphors, or respond to humor appropriately.

The individual may not react appropriately when presented with a common occurrence, such as a car breakdown or overflowing sink. This is due to impaired problem-solving abilities. Leaving the individual unsupervised may be dangerous in such cases, as they could cause injury to themselves or others.

A person who has difficulty recalling the date, time, or place is said to have orientation problems. The individual may also be disoriented to self, meaning that they cannot correctly recall personal information, such as birthdate, age, or family names.

Left-side neglect is a form of attention deficit that may occur from right hemisphere damage. Essentially, the individual no longer acknowledges the left side of their body or space. They will not brush the left side of their hair, for example, or eat food on the left side of their plate, as they do not see them or look for them. Reading is also affected as they do not read the words on the left side of the page, starting only from midline.

When human beings converse, they rely not only on words to convey messages, but also on body language, facial expressions, and intonation (how the voice rises and falls while speaking). Right hemisphere damage can cause problems with pragmatics , leading the individual to ignore or misinterpret such nonverbal cues and lose the meaning of the message. They may also lack facial expression when speaking ("flat affect") or speak in monotone or too rapidly. Social judgment is also impaired and the person may laugh at inappropriate times or say inappropriate things without realizing that they have done so.

Treatment

A speech-language pathologist (SLP) is a person trained in working with people with communication disorders. When a person experiences right hemisphere brain damage with resulting cognitive-communication problems, a referral to a speech-language pathologist may be warranted. The SLP will work with the individual and develop a treatment plan designed to improve the individual's cognitive-communication abilities.

What you can do

* Provide a consistent routine every day
* Use calendars, clocks, and notepads to remind the person of important information
* Decrease distractions when communicating
* Stand to the person's right side and place objects to the person's right if they are experiencing left side neglect
* Break down instructions to small steps and repeat directions as needed
* Ask questions and use reminders to keep the individual on topic
* Avoid sarcasm, metaphors, etc. when speaking to the individual
* Provide appropriate supervision to ensure the person's safety
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