Brain Dysfunction

Question 1

What is a closed head injury?

Answer 1

Damage at the site of the blow is called a coup. The brain has been impacted because the bone is pushing. The skull doesn’t have to be fractured. The brain is pushed to the opposite end of the skull, because of the pressure, this is known as a countercoup. Brain movement can twist and damage fibres. This mainly damages the corpus callosum, frontal and temporal lobes. A cerebral haemorrhage can occur when there’s blood trapped in the skull, a mass grows and this builds pressure.

Question 2

What is structural dysfunction?

Answer 2

Individual brain areas are damaged
e.g. stroke, dementia, traumatic brain injury

Question 3

What is functional dysfunction?

Answer 3

The whole behaviour of the brain is impaired but each individual brain area works fine
e.g. autism, OCD, depression

Question 4

What is an ischemic stroke?

Answer 4

80%

thrombotic: blood clot formed within the blood vessel, often builds up around atherosclerosis (60%)

embolic: clot formed outside of the blood vessel and travels to brain and becomes lodged, this can build up cholesterol coming from the neck blood vessels to the brain. This is atherosclerosis (20%)

Question 5

What is atherosclerosis?

Answer 5

build up of fats, cholesterol and other substances in or on the artery walls

Question 6

What is a haemorrhagic stroke?

Answer 6

20%

bleed from artery into the brain
blood builds up inside the skull and compresses brain tissue
brain soft, high blood pressure can squish it
interferes with normal cell function as there’s an abnormal flow of blood
some loss of blood flow is possible

Question 7

What’s the difference between arteries and veins?

Answer 7

Vein: carry blood towards the heart
Artery: carries blood away from heart

Question 8

How can a chronic ischemic stroke impact the Anterior Cerebral Artery?

Answer 8

Affects medial parts of the pre/post central gyrus
Sensory/motor loss
Executive dysfunction

Question 9

How can a chronic ischemic stroke impact the Middle Cerebral Artery?

Answer 9

Affects the pre-central (motor) an post-central (sensory) gyrus on one side
Leads to semi-paralysis and loss of sensation on one side
Affects language

Question 10

How can a chronic ischemic stroke impact the posterior central artery?

Answer 10

Affect vision, can cause blindness
Object recognition issues
Memory problems

Question 11

What’s the treatment for an acute ischemic stroke?

Answer 11

drug that can reduce clots
must be sure it’s not a haemorrhage
must be done early, within 3-4 hours
early intervention may reduce extent of stroke

Question 12

How can you treat a chronic ischemic stroke?

Answer 12

therapy for physical disabilities
therapy for language/cognitive abilities
adaptation to body/cognitive limitations
some natural recovery, particularly in young people

Question 13

What is the treatment for a haemorrhagic stroke?

Answer 13

aneurysm clip
these stay in the brain forever

Question 14

When does a closed head injury occur?

Answer 14

Rapid acceleration or deceleration

Question 15

How do brain tumours occur? How can they impact an individual?

Answer 15

Arise from glial cells
Can be derived from cancer elsewhere in the body

Can cause compression/injury to brain tissue as they expand, if cortex is involved then seizures are common, slowly progressive

Question 16

What are the requirements to diagnose someone with dementia?

Answer 16

Compromised memory and an impairment in 2 other cognitive domains
e.g. language, visuospatial skills, social, occupational, executive dysfunction

Question 17

What type of disease is Alzheimer’s?

Answer 17

Neurodegenerative: cannot be stopped, it’s an automatic process

Question 18

What are the behavioural deficits of Alzheimer’s disease?

Answer 18

behavioural: no changes in personality, psychosis, unawareness or denial of illness

no primary sensory or motor loss

Question 19

What is retrograde amnesia, anterograde amnesia, anomic aphasia, circumlocutory language disorder and empty language impairment?

Answer 19

Occurs in Alzheimer’s

Retrograde: inability to remember past
Anterograde: inability to form new memories

Anomic aphasia: language disorder leading to trouble naming objects

Circumlocutory language disorder: instead of using it’s name, a patient refers to the characteristics of an object or event

Empty language: phonological disorder, where the patient has difficulty organising their speech into sounds

Question 20

Where is the blood flow in Alzheimer’s disease?

Answer 20

lost: posterior/parietal areas

reserved: frontal lobes

Question 21

What is dendrite arbour reduction?

Answer 21

Less connections with other neurons
Occurs in Alzheimer’s

Question 22

What brain areas does Pick’s disease affect?

Answer 22

Frontotemporal dementia

Question 23

What are the cognitive and behavioural deficits of Pick’s disease?

Answer 23

cognitive: language and memory impairment (temporal), executive dysfunction (frontal)

behavioural: early prominent personality changes, poor judgement, socially inappropriate, euphoric, sexual indiscretions

no sensory or motor deficits

Question 24

What is Parkinson’s disease?

Answer 24

Hypokinetic
characterised by a partial or complete loss of muscle movement due to disruptions in the basal ganglia
there is a decrease in dopamine in the basal ganglia
inability to produce movement/muscle rigid

Question 25

What is Huntington’s disease?

Answer 25

Hyperkinetic
characterised by frenetic energy or activity
genetically transmitted
onset around 40 years old
less common than PD
increase in dopamine in basal ganglia

Question 26

What is the resting tremor in Parkinson’s disease?

Answer 26

Tremor of one hand is an early sign of PD
Often improve/disappear with purposeful function

Question 27

What are the behavioural changes in Huntington’s disease?

Answer 27

Depression, mood swings

chorea: involuntary movements of the face, neck and limbs
athetosis: slow, writhing movements confined to the limbs

Dementia (cognitive impairments)

Question 28

What is an open head injury?

Answer 28

Bone fragments penetrate the brain because the skull has been penetrated e.g. gunshots
Symptoms can undergo rapid and spontaneous recovery
To recover, you may need to surgically remove a small area of the brain

Question 29

What are aneurysms?

Answer 29

Balloon-like expansions of vessels that are usually weak and prone to rupture
Can develop from arteriosclerosis, embolisms or infections
Can cause severe headaches for years, as there is a pressure on the dura matter where there are many pain receptors