Right hemisphere brain damage (RHD) is the result of injury to the right cerebral hemisphere. The right hemisphere of the brain coordinates tasks for functional communication, which include problem solving, memory, and reasoning. Deficits caused by right hemisphere brain damage vary depending on the location of the damage.
Signs and symptoms
Visual processing Individuals with right hemisphere damage exhibit deficits in visual processing. They are only able to recognize the right half of a picture, symbol, or text. rather than seeing the concept as a whole. In a now widely replicated experiment, individuals with RHD showed an inability to grasp the whole of a given concept. These individuals were told to recreate an image of many small triangles making up the shape of an M. Their replications succeeded in depicting the triangle, but their arrangement of triangles was random, and evidently they only grasped the parts, and not the whole structure. Individuals with RHD also seem to struggle with inference revision, indicating an inability to drop focus, once given to a particular concept. In an experiment by Bloise and Tompkins, RHD individuals performed markedly worse at revising an inference they had about a paragraph when new information was presented that made their reading wrong. This was a sort of garden path paragraph, that RHD individuals had a hard time grasping.
Cognitive and communicative
General Patients with right hemisphere brain damage most commonly have difficulties with attention, perception, learning, memory, recognition and expression of emotion, and neglect. Other frequently occurring, though slightly less common, deficits include reasoning and problem solving, awareness, and orientation. It is also common for patients with right hemisphere damage to have a flat affect, lack of emotional expression, while speaking. Additionally, these patients commonly have difficulty recognizing other people's emotions when expressed through facial expressions and tone of voice. This lack of ability to recognize emotion suggests individuals have an impaired theory of mind, the ability to recognize the thoughts and feelings of others outside of one's self. Although these deficits alone may complicate therapy, the patient may also exhibit anosognosia, or ignorance of his or her impairments. Due to possible anosognosia, it is common for patients to not become frustrated or upset when they are unable to complete tasks they were previously able to complete. Unlike those of people with aphasia, the speech patterns of individuals with right hemisphere damage are not typically characterized by "word finding problems, paraphasias, circumlocutions, or impaired phonological processing." Circumlocution in persons with RHD tends to center around general concepts, not specific words. For example, in describing what brought a RHD-affected individual to the hospital, though the patient would likely remember the word "stroke" and other specific words to describe his situation, the RHD impairment to his discourse level and cognitive processes would likely prevent him from describing the situation in a coherent manner.
Linguistic impairments
Syntax The syntax of RHD-affected individuals tends to be "accurate and varied"; unlike people with aphasia, they tend not to have difficulty with word retrieval. In addition, people with right hemisphere damage usually understand the literal meaning of most statements. Linguistically, in cases in which RHD patients seem to have syntactic deficits, they are typically the result of problems with semantic processing.
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