Updated on June 11, 2023
Knowing a little bit about brain anatomy is very useful for stroke survivors and their carers; it will help you to recover fast, and better. For carers, the knowledge will give you creative ideas to improve your quality of care. And, it will also help you to reduce your care fatigue and improve your relationship with the stroke survivor.
Let us begin with the brain’s surface.
Brain surface
The brain surface is full of ridges (bumps) and valleys (grooves) (see Figure 1).
Experts have given specific names to recognize these bumps and grooves. In the medical field, the bumps are named gyri (its singular word is gyrus) and grooves sulci (its singular word is sulcus).
Bumps (ridges) and grooves (valleys) on the brain surface:
The purpose of these bumps (ridges) and grooves (valleys) is to increase their surface area. As a result, the surface areas assigned to specific jobs have enough space for their work.
Naming the brain surface regions (lobes):
Figure 1:
Brain surface and its regions (Image source: NIH)
Experts have categorized the brain surface into five different regions; they call it lobes: The frontal lobe, parietal lobe, two temporal lobes, and occipital lobe. This naming depends on the region placed within the skull. Interestingly, each lobe carries out specific jobs. Figure 1 shows those four lobes on the left half of the brain. Similarly, we have the same mirror lobes on the right side too.
Demarcations of the lobes: The Central Groove (Central sulcus)
The central sulcus, also known as the central groove, is a prominent dividing line in the brain that separates the frontal lobe from the parietal lobe (Figure 2). It plays an important role in the function of the brain and in the event of a stroke.
There are several other grooves as well. Another groove sits between the Parietal lobe and the Occipital lobe and another large groove, called the Lateral fissure, separates the Parietal lobe from the Temporal lobe.
Figure 2:
Brain surface regions:
Source: (Image courtesy: S Bhimji MD; from Neuroanatomy, Postcentral Gyrus Copyright © 2020, StatPearls Publishing LLC. under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/),
Pre-cental gyrus (The area in front of the Central sulcus)
The precentral gyrus (coloured red in Figure 2) is a part of the brain located in the frontal lobe, near the central sulcus. It controls our muscle movements, so we can perform tasks like walking, typing, or brushing our teeth. If a stroke occurs in the area of the central sulcus that controls movement, it can lead to weakness, paralysis, or difficulty with coordination on one side of the body.
Post-central gyrus (The area behind the Central sulcus)
The post-central gyrus (coloured blue in Figure 2) situates behind the Central sulcus. It is a part of the brain located in the parietal lobe. This place receives sensory information from the body, such as touch, temperature, and pressure and then feedback to the pre-central gyrus for action. For example, if we touch a hot stove, the post-central gyrus immediately receives that information through nerves via neurons. Then, after processing it, this information sends to the pre-central gyrus for immediate action: Withdraw the hand!
However, if someone has a stroke and the post-central gyrus is damaged, they may experience changes in their perception of sensation, such as increased or decreased sensitivity to touch. This can affect their ability to perform everyday tasks, such as dressing or eating.
As a caregiver, it’s important to understand the role of the post-central gyrus so you can identify and manage changes in sensory perception and help your loved one remain comfortable and safe. Knowing about this area of the brain can also be useful in rehabilitation, as healthcare professionals and caregivers can work together to improve the processing of sensory information and support recovery.
Brain regions (lobes) in detail:
Frontal lobe
In Figure 2, I am starting my walk from the front end of the Frontal lobe. When I climb to the top, I meet the Central groove (sulcus). The Frontal lobe ends there.
We – humans – own the largest Frontal lobe proportionate to the body size among all animals.
This lobe carries out jobs that no other animal can do.
This part is responsible for many important functions such as
- movement,
- decision-making,
- problem-solving, and
- emotional control.
When a stroke occurs in the frontal lobe, it will disrupt one or more of the above jobs. For example, a stroke in the frontal lobe can result in motor impairments such as weakness on one side of the body or difficulty with coordination and balance. A stroke in this area can also result in changes in behavior, such as difficulty with decision-making and impulse control, as well as changes in emotional regulation, such as depression or irritability.
As a caregiver for a stroke survivor, understanding the potential impacts of a stroke on the frontal lobe can help you better understand the specific needs of your loved one and how to best support their recovery. For example, if the stroke survivor is experiencing motor impairments, the caregiver can assist with physical therapy exercises that target the affected areas.
Additionally, if the stroke survivor is experiencing changes in behavior or emotional regulation, the caregiver can work with healthcare professionals to develop strategies to manage these symptoms and provide a supportive and understanding environment. This can include strategies such as
- Maintaining a structured routine,
- Avoiding overstimulation, and
- Providing opportunities for stroke survivors to engage in activities they enjoy.
How stroke caregivers can explain signs and symptoms to stroke survivors when their frontal lobe is affected by a stroke
As a stroke caregiver, you can explain the signs and symptoms of a stroke affecting the frontal lobe as follows:
It’s important to remember that every stroke survivor experiences symptoms differently and the severity of symptoms may vary. Encourage the person to seek medical attention immediately if they experience any of these symptoms.
- Movement and coordination problems: The person may have difficulty with movements on one side of their body, including their arm, leg, face or tongue. They may also have trouble walking, standing or maintaining balance.
- Speech difficulties: The person may struggle to speak or understand speech. They may also have trouble forming words or understanding what is being said to them. This specific speech problem is identified as Broca’s aphasia. You can read more about it through this link.
- Changes in personality or behavior: The person may experience changes in their mood, behavior, or decision-making abilities. They may also display impulsive or inappropriate behavior.
- Problems with memory: The person may have trouble remembering new information or events. They may also have trouble recalling events from their past.
- Attention and focus issues: The person may have trouble paying attention or staying focused on a task. They may also have trouble completing tasks that require multiple steps.
To help the stroke survivor understand the impact of the stroke on the frontal lobe, it may be helpful to use analogies or real-life examples to illustrate how these impairments can affect their daily life. You can also use visual aids such as diagrams or videos to help them understand the brain and how it works.
In terms of rehabilitation, it’s important to emphasize that with appropriate therapy and support, many people with frontal lobe damage can make significant progress in their recovery. This can involve a combination of physical, occupational, and speech therapy, as well as other interventions such as cognitive therapy and support groups. By working with their rehabilitation team, stroke survivor can learn new strategies and techniques to help them overcome their impairments and improve their quality of life.
It’s also important to emphasize that recovery is an ongoing process, and progress may be slow, but with persistence and hard work, the stroke survivor can make meaningful gains over time.
Parietal lobe
As soon as I jump over the Central groove from the Frontal lobe’s edge to the other side, I land on the Parietal lobe. It lays behind the Frontal lobe. The Parietal lobe extends back until it meets the next lobe – The occipital lobe.
We see the upper-left side view of the left Parietal lobe in Figure 2.
The parietal lobe reads messages related to taste, touch, and temperature and controls our balance while standing and walking. That means if this area inflicts any damage, we will not be able to taste, feel touch, or temperature and will fall.
As a stroke caregiver, you can explain the signs and symptoms of a damaged parietal lobe to a stroke survivor in simple language by using the following steps:
- Explain what the parietal lobe is: You can tell the stroke survivor that the parietal lobe is a part of their brain that helps with feeling sensations in their body, understanding space, and moving their body smoothly.
- Describe the common symptoms: Let the survivor know that if the parietal lobe is damaged by a stroke, they may experience numbness, tingling, or decreased sensitivity on one side of their body. They may also have trouble with tasks that require coordination, like writing, drawing, or balancing.
- Use everyday examples: To help the survivor understand these symptoms, you can use everyday examples, such as explaining that numbness in their arm or leg might make it hard for them to put on their clothes, or that trouble with coordination might make it harder for them to walk.
- Emphasize the importance of rehabilitation: Explain to the survivor that rehabilitation can help them get better and improve their abilities. You can emphasize that while recovery can be slow, they can make progress over time with therapy and support.
Temporal lobe
Now, walk with me over to the brain’s left side to meet another larger groove, called Lateral Fissure.
Once I cross over this fissure, I land on the Temporal lobe. The part above is the side view of the left Frontal lobe.
The Temporal lobe’s main job is to understand and interpret the language.
As a stroke caregiver, you can explain to a stroke survivor that the temporal lobe is an important part of the brain that is responsible for functions such as hearing, memory, speech, and language. If the temporal lobe is damaged by a stroke, the following symptoms and signs may be observed:
- Hearing loss: The person may experience difficulty hearing or understanding speech, leading to communication difficulties.
- Memory problems: They may experience difficulty with recalling information, retaining new information, or finding the right words.
- Speech difficulties: They may experience slurred speech, stuttering, or difficulty expressing themselves.
- Visual problems: They may experience visual hallucinations or difficulty recognizing faces or objects.
- Seizures: They may experience seizures, which are sudden, uncontrolled movements or changes in behavior due to abnormal electrical activity in the brain.
Occipital Lobe
Behind the parietal and Temporal lobes, we find the Occipital lobe. This lobe spreads over the back of the brain. Without this area, we cannot see, recognize, and interpret anything although we have eyes.
As a stroke caregiver, you can explain the signs and symptoms of a damaged occipital lobe to a stroke survivor in the following way:
- Explain what the occipital lobe is: You can tell the stroke survivor that the occipital lobe is a part of their brain that helps with seeing and interpreting what they see.
- Describe the common symptoms: Let the survivor know that if the occipital lobe is damaged by a stroke, they may experience vision problems such as decreased vision, double vision, blurred vision, or the loss of peripheral vision.
- Use everyday examples: To help the survivor understand these symptoms, you can use everyday examples, such as explaining that decreased vision might make it harder for them to read or see objects clearly, or that double vision might make it difficult for them to watch TV or recognize people’s faces.
- Emphasize the importance of rehabilitation: Explain to the survivor that rehabilitation can help them get better and improve their vision. You can emphasize that while recovery can be slow, they can make progress over time with therapy and support.
In our next journey, we will meet the “two little humanoids” who live on our brain surface.
