Thursday, March 11, 2010

The Impact of Frontal Lobe Injuries

Our frontal lobe is the emotional control center of our brain and is the director of our personalities. For this reason, when we receive brain trauma to the frontal lobe, many areas of our life will be affected.

Because of the size and location of the frontal lobe, this is the most common area to be injured. A traumatic injury to this part of our brain can affect problem solving, short term memory loss, motivation, judgment, impulsivity, behavior, perception, attention span difficulties, rationality, apathy, inhibition (possibly social or sexually inappropriate behavior), strategizing problems, and decision making.

A very common deficit of frontal lobe injury is perseveration which is non-compliance with rules. There may also be difficulty in interpreting cues to guide behavior. This can have a serious affect on interpersonal relationships; especially if perseveration is not acknowledged by the survivor.

A brain injured survivor is considered to be in denial when deficits are unacknowledged. Denial hinders rehabilitation and recovery. It also has a detrimental affect on relationships.

Personality changes can generally be significant with this type of injury. The changes will be dependent upon the survivor's deficits and upon his/her acceptance of the injury and willingness to work towards a new life through adaptations and adjustments.

Studies have found that some survivors with frontal lobe injuries have difficulty understanding some types of humor; many prefer the slapstick variety. In some cases however, the personality may become flat with no sense of humor and little facial expression.

Abstract thinking can also sometimes be affected. The ability to understand others allows us to feel empathy, sympathy, and to realize when others are being sarcastic or deceptive. Other areas of the brain can sometimes adapt to be able to take over the functions of the damaged area; this is more likely if the injured person is young. Additionally some sufferers of a frontal lobe injury may have problems consistently performing a task which may make job performance difficult.

Intensive therapy following this type of injury, according to some studies, is important towards achieving successful rehabilitation. Sadly, in many communities there are few resources available for brain injured survivors. And in some cases unfortunately, the injured person is reluctant to participate in programs that would assist him/her in recovery.

Frontal lobe injuries change the brain injured survivor's life; in most cases forever. This will be more evident in some people than in others because no two brain injuries are the same.


  1. as I read your post i am crying. my son was shot in the head by a .22 calibre rifle -- freak accident... and was struck in the front lobe (and the bullet travelled through a few other lobes) He is doing miraculously well but the slap stick humour is so evident with himnow. He used to have a razor sharp sense of humour with the tongue to match!
    I am realzing now that we should have been educated more about where the injury/damage occured and what to expect... so i wouldnt feel like I was crazy. Thank you for posting and please feel free to stop by my blog as I am telling our family's story there (we are a family of 3 TBI survivors)

  2. Ah, so THAT'S what's wrong with me ;)

    But seriously, when I felt down a flight of stairs in 2004 and smashed the back of my head on the top three steps, I believe that the back-and-forth (coup-contrecoup - back-and-forth slamming) impact really affected my frontal lobe area. I used to have a very involved sense of humor. I was always the one with a quick joke. That changed a lot after my injury. All of a sudden, nothing was funny, and I couldn't figure out why anything had ever been funny before. That was probably the biggest problem, aside from a lot of money (including my retirement savings) that "magically disappeared" before I figured out that something was terribly wrong with my reasoning and cognitive/behavioral functioning.

    Oh, well...

    One thing to keep in mind is that denial is not necessarily psychological. The whole issue of denial by TBI survivors is fascinating - we often literally do NOT know that something is wrong. We aren't in denial - we have no clue, and we have no reason to know that we have no clue, because our brains are telling us we're fine, and no amount of reasoning can break through, without the right approach.

    What is the right approach? I cannot speak for anyone else, but for me, I need to ask myself direct questions with yes/no answers -- instead of "How do I feel?" I need to ask myself "Am I angry?" or "Am I sad?" or "Am I frustrated?" If I don't give myself something specific, I cannot easily pinpoint where I am "at" at a given point in time.

    If it weren't so maddening, TBI would be the most fascinating line of study in the world.

    Well, best of luck!