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A Guide to Right Hemisphere Brain Damage

Constant Therapy | Traumatic brain injury, Stroke

Leaving food on half their plate… Drawing only half an object… Starting writing from the middle of the page… Insisting they waved their left hand when they actually didn’t… If you’ve observed any of these behaviors, you’ve seen some of the amazing, yet problematic neurological symptoms of right hemisphere brain damage caused by stroke or traumatic brain injury.

Right Side Brain Damage Provides Only Half The Picture

Our brains are divided into 2 halves – the right side (or hemisphere) and the left side – connected in the middle by the corpus callosum. The functions of each are distinctly different so that when one side is damaged by stroke or brain injury, only the functions that are controlled by that injured side are impacted.

With right hemisphere brain damage (known as RHBD or RHD), a person may have trouble with things like attention, perception, and memory, as well as loss of mobility and control on the left side of the body, since each hemisphere controls functions on the opposite side of the body.

The other problem making this even more difficult is that often, a person with RHBD is not even aware of their problems, and may deny they exist at all.

By increasing awareness of the potential effects of right side brain injury, our goal is to help caregivers and families of individuals with RHBD recognize, understand, and cope more effectively with the challenges their loved ones are facing.

What Is Controlled By The Right Side Of The Brain?

In general, the right side of our brain is in charge of visual awareness, imagination, emotions, spatial abilities, face recognition, music awareness, 3D forms, interpreting social cues, and left-hand control. It performs some math, but only rough estimations and comparisons.

The brain’s right side also helps comprehend visual imagery and make sense of what we see. It plays a role in language, particularly in interpreting context and a person’s tone, staying on topic in a conversation and organizing thoughts and ideas.

How Does RHBD Impact Daily Life?

Injury to the right side of the brain may result in cognitive and communication problems. Difficulties with memory, attention and components of executive function are most common, including planning, organizing and self-awareness in the following areas:

  • Attention — Difficulty concentrating on a task or focusing on what is said or seen.
  • Visual & Spatial Perception — Processing information in the left visual field, resulting in trouble judging location and objects in their surroundings. This is called Left Neglect.
  • Reasoning & Problem Solving — Difficulty identifying that there is a problem and generating solutions.
  • Memory — Difficulty recalling previously learned information and learning new information.
  • Social Communication — Difficulty interpreting abstract language such as metaphors, making predictive inferences, understanding jokes, and nonverbal cues. Affect, or emotional expressiveness, is often flat and reduced. There may be difficulty filtering comments during conversations.
  • Organization — Difficulty arranging information and planning, reflected in communication difficulties such as telling a story in the right order, giving directions, or maintaining a topic during conversation.
  • Insight — Difficulty recognizing problems and their impact on daily functioning.
  • Orientation — Difficulty recalling the date, time, or place.
  • Musicality — Trouble picking up on certain sounds, which could result in miscommunication or inability to appreciate the musicality of speech and tone.
  • Speech — Voices can sound monotone or unnatural.
  • Emotional Indifference — Acting as if nothing serious – physical or mental – needs to be addressed, when this may not be the case.
  • Loss of Mobility & Control of The Left Side of the Body — Damage to the right side of the brain can result in a loss of functionality or weakness (called hemiparesis) in the left side of the body. 

RHBD Is Complicated By Associated Neurological Self-Awareness Issues

Perhaps the most difficult challenges facing survivors of stroke or brain injury with right side damage is that they are often unaware they are missing half of the picture. They may be unaware of things on the left side, plus, may deny the need to get help for their condition.

Right side brain damage may result in the following cognitive challenges:

  •  Hemispatial (or Unilateral) Left Neglect — Refers to difficulty seeing or processing awareness of anything on the left side, including inability to respond to people or objects on the left, or being unaware there is a problem on the left. For example, they may forget that they are able to move their left arm or leg. Or they may fail to eat food from the left side of their plate, or fail to comb the hair on the left side of their head. This may have serious consequences for safety.
  • Denial Syndrome or Anosognosia — Considered a sub-feature of Hemispatial Neglect, it is a complex neurological condition (rather than a psychological one) that occurs when specific brain regions are damaged by a stroke, rendering a survivor unable to move one part of their body, but because a closely related region of the brain is still intact, it tells them that their bodies are responding normally. The result is that survivors may believe that they are carrying out their physical functions in a normal fashion despite their actual inability to do so. This can lead to refusal to undergo rehabilitation.

How Is Right Hemisphere Brain Damage Treated?

Like other damage resulting from brain injury or stroke, RHBD is treatable. In rehab, Speech-Language Pathologists, Occupational Therapists, and Physical Therapists, using evidence-based practice, work with survivors in one-on-one therapy to improve skills and limit the consequences of right side brain damage.

Science tells us that the most important element in rehabilitation is carefully directed, focused, repetitive practice, so expect this kind of therapy to form the basis of most rehab programs. In addition, clinicians may treat left-neglect by focusing on conscious awareness and using contextual cues that can remove ambiguity.

The goal of therapy programs is always to help survivors regain lost skills and become more independent.

Tips For Caring For Someone With RHBD

At home, caregivers can take specific steps to help loved ones deal with limitations of right hemisphere brain damage, and also help improve awareness of their recovering side. And caregivers should take steps to avoid caregiver stress in the process. Here’s how:

  • Keep The Environment Safe — Keep all items that have the potential to be dangerous (like cleaning chemicals or sharp objects) in a secured or out-of-the-way place.
  • Decrease Environmental Clutter & Distractions — Too much visual or auditory stimulation in the environment may be confusing.
  • Help Them With Routines & Planning — Try to have a routine every day so your loved one knows what to expect. Use calendars, clocks, and notepads to remind them of important information. Break down directions into small steps and repeat as needed.
  • Use a Caring Approach — Recovering from stroke or brain injury can be frustrating for the survivor. Avoid sarcasm or scolding, even if your patience is thin. For example, if they haven’t seen the fork to their left, gently remind them by saying “look to the left,” “here is your fork” or drawing their hand to the fork, rather than saying something which may come across as condescending, such as “What did you forget?”
  • Be Sensitive To The Survivor’s Visual & Sensory Difficulties — Talk to the rehabilitation team about how to best support the survivor’s needs. For some individuals, it may be appropriate to place critical items the person needs to their right side if they have trouble seeing or sensing things on their left side.
  • Help Increase Awareness Of The Left Side — Hold their hand, touch their arm, or stand on their left side during a conversation to help them become more aware. Placing non-critical items like the TV remote or a glass of water on the neglected side may encourage them to look and reach for objects on that side. Talk to the rehabilitation team about how best to support the survivor’s needs so that the neglected side is incorporated into daily tasks, but is not too frustrating for the survivor.
  • Encourage Scanning — Have your loved one fully scan (turn their head or move eyes from side to side to see) their surroundings to adjust for any loss in field of vision. For pen-and-paper tasks, using your finger to guide the eye gaze or highlighting the left margin of a page can be helpful visual reminders to scan. Place a comfortable chair next to the bed on the left (the neglected) side, encouraging them to look in your direction as you speak.

As much as we know today, researchers still feel there is a need for significantly more treatment research for cognitive and communication disorders associated with RHBD, and are therefore continuously studying the effects of right side brain injuries. If you are a survivor or a caregiver, be sure to stay up-to-date on research developments in the field, so that your recovery can benefit from the very latest information.


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  1. Joanne Roth

    Excellent article.

  2. Mary Gouldsbrough

    so brilliantly spelt out!! thank you. I’ve been caring and care managing for my mum since her stroke. This is her ALL over, but the agency carers find it really difficult to understand… This article will help me to share what I’ve observed over a long time with them very quickly. Thank you so much.

    • Constant Therapy

      We’re really happy to hear that this article felt resourceful, Mary. We wish your mom the best in her recovery.

  3. le

    Your means of explaining the whole thing in this article is in fact nice, all can without difficulty understand
    it, Thanks a lot.

  4. Janetta McCombs

    My son was in a car accident and his right side of the brain is damaged he moves every part of his limbs his eyes follows you around the room he cries whenever I leave the hospital he have good emotions he understand what he can’t speak I would like to know more about the damage right side of the brain

    • Lisa Gundlach

      That sounds so challenging to process! The brain is a very complex mechanism, and everyone’s accident and accompanying injuries are unique to them. Reach out to your son’s medical team, such as his neurologist or primary care physician, and ask if they can tell you more about what parts of his brain were injured and what you can expect in terms of your son’s specific recovery journey.

  5. Leena Sujit

    Very much helpful content. My husband got right brain swelling and undergone 3 surgeries

  6. Michael Powell

    What about the left side of the brain? I need this article for the left side.

  7. Marla Larochelle

    My son had childhood epilepsy, and I have right hemisphere brain damage from the seizure. I he has been challenged throughout his school years and now as an adult. His wife has divorced him because of the effects of right hemisphere brain damage. Throughout is adult life he has had trouble keeping jobs. He needs help functioning as an adult in his daily life. We have no where to turn for help. What do you suggest?

    • Constant Therapy

      Hello Marla, it sounds like you and your son have endured a lot over the years. We are sorry to hear that he is struggling. While we cannot provide medical advice, here are a few links that may be useful to you. Best of luck to you and your son!
      This article explains why activities of daily living are difficult for people with brain injuries and provides tips on how to navigate them
      This article discusses support groups, which is crucial for people who may be having difficulties emotionally, behaviorally, or in their relationships
      This article details which Constant Therapy exercises are important for those with right hemisphere brain damage and how they are helpful

  8. I hate my life

    Probably why no one wants to go with me anywhere during day. Usually only like to be with me indoors at night time. Why the person I’ve lived with for a few years criticizes how I do anything, like why am I cutting the cake that way, or placing food on the plates that way, why don’t I do it this way. Or why he always sits on the left side of me. Moron I already know I have brain damage, my visual field is very limited, I’ve lost the ability to focus my eyes, that my face is a little drippy in the left side, my balance is sucky, and that I can’t remember dates & times & have trouble remembering newly processed information and an extreme difficulty in repeating back information especially if its the next day than just forget about it unless I have it written down or links bookmarked or the information of printed out to give to someone than I can share. I can hold a basic conversation. I am however not unaware of my inabilities. I became aware very quickly by hearing a playback if y speech and conversational abilities many years ago, it hurt my feelings deeply, I have improved tremendously, but why would someone decide to be with me then if it bothered them when they got to know me. Yes it is also confusing when there is too much noise from multiple areas and too much in my visual field. No doctor has ever done anything for me though, not a damn thing. It’s not fair at all. I hardly ever have a dream either. My mathematical skills are basic 2+2, I can estimate though, I still have an imagination, my ability to judge depth is awful, low light settings good grief. Due to loss of precise fine motor skills & using accuracy with other motor skills my body hurts,using other muscles more than should be. Putting on make up is a nightmare. Keeping my attention is difficult, I loose my own patience with others if they take too long explaining something, and they get upset with me because I don’t want to hear the same thing over and over again just get to the point already the conclusion before I forget what the heck you’re talking about and go on to the next step. It’s not right. Especially if whatever they are doing is the opposite of helpful but only furthers the progression of my decline. I can write this comment but I wouldn’t be able to tell this comment as the listener will either ask a million and one questions in the middle of it if they do not know what’s been going on or they will make comments to contradict what I’m saying as being valid and then I am unable to stay on topic or keep my structure with my sentencing and struggle with addressing my needs & wants & solutions I am trying to get to. I think they obviously know what’s wrong with me, but they’re to shallow to just come out with it that they would rather have the life and keep me separated from it. So they aren’t asked dude whats wrong with her or why is she so different. What’s her problem or is she ok. She’s weird. She don’t belong. Whatever. And I have a lisp that though I’ve had since I was a kid from a different brain damaging wasn’t till the 2009 that I had an event that caused me to have difficulties interacting with others and difficulties not blending in, difficulties with my day to day & having a good job, being on time, not missing important dates, or important steps. I guess according to who I live with I happen to miss that others have the what the heck attitude written all over their faces or something and were like lost. I dunno. But also for some reason they like happened to know what was going on well why is that? Guess he likes to speak about me to others before he introduces me to anyone instead of just saying something to my face. Sucky that I improved so much before I met this person and Got obviously far worse after having met him. People are way way to judgemental & too needy on having things just perfect. Then why dont they lead the show instead of making a public display out of me just so they can shove me back inside away from every one and everything or insist I do everything alone. 🙁

    • Constant Therapy

      Hi there, thank you for sharing some of your story with us. We are so sorry to hear that those close to you are judgmental and impatient regarding your condition. Having a stable support system can make a big difference in one’s life post-TBI, and it sounds like you have been doing much of this work on your own. For that reason (and many more!) you are incredibly strong! If you are interested, we have some articles outlining the value of support groups and how to find one in your area. You can read one of those here. Please let us know via email at if there is anything else we can do to help. We believe in you!!


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