Flashcards in Neurological Disorders Deck (105):
Blunt Brain trauma
Head strikes hard surface or a rapid moving object strikes the head.
Dura mater is intact and brain tissue is not exposed.
What kind of brain injury can Blunt trauma cause?
Focal (local) or diffuse (general) brain injuries.
Open Brain Trauma
injury breaks the dura and exposes the cranial contents to the environment.
what kind of injury does open trauma cause?
Causes primarily focal injuries.
What are types of injury caused by Bunt Trauma?
Coup injury and Contrecoup
Injury directly at the point of impact
Injury on the polar opposite of the site of impact
Focal Brain Injury
Observable brain lesion
force of impact typically produces contusion
What are different types of concussions?
Mild and classical
temporary axonal disturbance causing attention and memory deficits but NO loss of consciousness
Type I mild concussion
Type II Mild concussion
retrograde amnesia of prior minutes
Type III Mild concussion
confusion with retrograde (greater than a few minutes) and anterograde amnesia
loss of consciousness (for more than 6 hrs)
physiological and neurologic dysfunction without substantial anatomic disruption
anterograde and retrograde amnesia
What causes the loss of consciousness in grade IV concussions?
Disconnection of cerebral systems from the brain stem and reticular activating system
Your friend takes a huge hit as he is running for the goal line playing “flag football”. He is slow to get up and unsteady on his feet. He goes over to the sidelines and can’t remember what day of the week it is. The next day, he still can’t remember what happened for several hours before or after the game. How severe was the concussion he just experienced?
Any Abnormalities of he brain caused by a pathologic process in the blood vessels
loss of blood flow to brain area
Bleeding within the brain
Transient Ischemic Attacks (TIA)
usually no long term dysfunction (<24hrs)
a warning sign of something more severe.
What are different types of cerebrovascular accidents?
from an aneurysm
most common cause is hypertension
arterial occlusions caused by thrombi formed in arteries supplying the brain or in the intracranial vessels
an thrombus formed outside the brain
What are examples of Intracranial Aneurysms?
Saccular (berry) Aneurysms
Fusiform (giant) aneurysms
Saccular (berry) aneurysms
Exacerbated (caused) by hypertension
increases risk of hemorrhage
the walls move out on one side of the vein, kinda like it's gonna go through exocytosis
Fusiform (giant) Aneurysms
walls move out on both sides like when you blow up ling skinny balloons
group of dilated blood vessels with no other brain tissue
these are not that dangerous because they rarely hemorrhage.
small abnormally dilated capillaries. These are not that dangerous because they rarely hemorrhage.
abnormal cluster of veins draining a region of brain tissue. These are not that dangerous because they rarely hemorrhage.
Arteriovenous malformation (AVM)
arteries and veins in tangle of malformed vessels
"tangle of worms"
increase in the fluid (intracellular or extracellular) with the brain
What are different types of cerebral edema?
increased capillary permeability
block active transport
problem transporting ions so you get water movement due to ion imbalances
follows cerebral infarction
increased capillary permeability
block active transport (ion imbalances)
CSF moves across ependymal cells from ventricles to interstitial space
type of interstitial cerebral edema
result of excess fluid within the cranial vault, subarachnoid space, or both.
What is hydrocephalus caused by?
an interference in CSF flow.
-increased fluid production
-obstruction within the ventricular system
lips purse whenever touched lightly
twitch of cheek when stroking the palm
death of the cerebral hemispheres exclusive of the brainstem and cerebellum
do you have behavioral or environmental responses in cerebral death?
which functions are normal during cerebral death?
respiratory, cardiovascular, temperature control, and GI function.
survivors of cerebral death
remain in coma
emerge in a vegetative state
-akinetic mutism (AM)
disruption in balance of excitation and inhibition signals
the sudden transient alteration of brain function in seizures is caused by:
an abrupt explosive disorderly discharge of cerebral neurons
tonic-clonic (jerky, contract-relax) movements associated with some seizures.
partial (focal) seizures
experience of a second seizure before the person has fully regained consciousness/capacity from the preceding seizure or a singe seizure lasting more than 5 minutes
what are some consequences of seizures
250% increase in adenosine triphosphate (ATP) demand
cerebral oxygen consumption increased by 60%
cerebral blood flow also increases aprox 250%
available glucose and oxygen are depleted
what are some consequences of the depletion of available glucose and oxygen during seizures?
may produce secondary hypoxia and acidosis
may result in progressive brain tissue injury and destruction
to be seized by a force from without
two signals of seizure
partial seizure prior to "real" seizure
some sign like headache prior to seizure
treatment for seizure syndromes
fat-rich diet reduces seizure frequency
Cerebral edema caused by increased capillary permeability would be called:
destruction of the CNS due to inflammation of the vessels in the CNS and demyelination of nerve cells. A development of scars throughout the CNS
What is the cause of MS
interaction between autoimmune conditions, genetic make-up and viral infections of the brain.
(herpes simples and epstein barr)
what are clinical manifestations of MS?
they are highly variable. It can attach any part of the CNS at any time. Which can cause problems with motor, sensory, cognitive, or autonomic system function.
how do you diagnose MS?
High IgGin CSF
multiple lesions throughout the CNS detected by MRI.
when does MS usually happen?
between 20-40 yrs old.
in which gender is MS more prevalent?
where is MS more common?
the further away from the equator you are.
what type of disease is MS thought to be
What are the different types of MS
Mixed MS (general)
commonly have central problems (vision disturbances, memory deficits, mood alterations) along with motor/sensory impairments
mostly sensory and motor deficits
mainly motor-loss of coordination
what are some treatments for MS?
prednisone (or other anti-inflammatory steroids) to decrease inflammation
interferon beta 1b and beta 1a
estrogen (clinical trials) for women
Acute confusion states
mental disorder with deficits in attention and coherence of thoughts and action
-secondary to drug intoxication, metabolic disorder, or nervous system disease
progressive failure of cerebral functions not caused by an impaired level of consciousness
classifications of dementia
parkinson and huntington disease
most common neurodegenerative disease worldwide
what causes alzheimer's disease
degeneration of the brain manifested by:
relates to genetic factors and poorly identified environmental factors.
Morphological changes in Alzheimer's disease
decreases surface area of the brain due to a decrease in size of the folds
decreased blood flow to the brain
intracellular tangles of microtubules and microfilaments (detected upon autopsy)
areas of degenerated cells that coalesce around a fibrous core (detected upon autopsy) formed from a protein named beta amyloid
Clinical Manifestations of alzheimer's disease
slow and progressive change in memory (recent memory loss first)
changes in mood
changes in motor function (late)
Our results suggest that _________levels may be a risk factor for dementia, even among
persons without diabetes
alzheimers disease is typifies by ______
_____ enhances breakdown of amyloid
which then prevents plaques
how is insulin resistance related to alzheimer's disease?
insulin resistance reduces cognitive function
insulin resistance _____ risk of dementia
ketones _____ cognitive function
is there an approved test for early diagnosis of alzheimers disease?
how do we diagnose alzheimers disease?
by ruling out other diseases and following the course of the disease
what are some preventative measure for alzheimers'
diet rich in folate
reduce refined carbs
increase essential fatty acids
what is treatment for alzheimers?
there is no cure
destruction of brain dopamine neurons in the striatum and substantia nigra
coordinate the brain centers that monitor body position
involved in neuronal circuits that permit pre-programmed movements (movements w/o thinking)
inhibits the acetylcholine that cause muscle movement (reduces spontaneous, involuntary movements)
Clinical manifestations of parkinson's disease
tremor at rest
akinesia (pill rolling)
dementia, slow thought process, or depression
disorders of righting and equilibrium
Diagnosis for parkinsons
case history, course of disease, and brain scans
environmental factors relates to parkinsons:
exposure to anesthetics
exposure to hydrocarbons
drinking well water
working with wood or wood products
with in janitorial services
Treatment of Parkinsons
Levodopa (Ldopa) precursor to DA.
inhibitor of monoamine oxidase (the enzyme taht degrades DA)
electrode placed in basal ganglia of the brain
Huntington Disease is autosomal ____
a type of chorea (family of dyskinesias)
sever degeneration of the basal ganglia and frontal cerebral cortex
disrupted thought process
clinical manifestations of huntington's
abnormal movement (hyperkinesia)
dementia characterized by irritability (often becomes violent), apathy, inability to plan and organize, loss of short term memory, and slow thinking.
euphoria or depression (bipolar, swing back and forth)
changes in different parts of the bain (basal ganglia) detected by MRI