Lecture 2: TBI & CVA

Question 1

What is delayed axotomy?

Answer 1

The result of severe axonal injury: when an axon is damaged, many neurotransmitters are released, specifically glutamate > this causes an excess of calcium > overexcitation of the already injured neuron

Question 2

What is the difference between a commotio cerebri and a contusio cerebri?

Answer 2

Commotio cerebri is a concussion (shaking of the brain, no permanent loss of cognitive functioning)

Contusio cerebri is a contusion (bruising of the brain, in most cases permanent loss of cognitive abilities)

Question 3

What is the most documented consequence following TBI?

Answer 3

Decreased speed of information processing (mental slowness)

Question 4

What is a cogniform disorder / post-concussion syndrome?

Answer 4

If complaints are following a mild injury, but last for longer than 3 months, patients may present themselves with an excessive number of not proportional complaints.

Personality and inadequate coping styles are predictive of these complaints.

Question 5

What is the difference between a TIA and a CITS?

Answer 5

TIA: neurological deficits dissapear within a short period of time (less than 45 min) and there is no evidence of infarction on a CT scan.

CITS: symptoms last longer than 45 min, but compared to a full stroke, less than 24 hours. Here, there is evidence of recent infarction on a CT scan.

Question 6

What is the difference between a deep and lobar intracerebral hemorrhage?

Answer 6

Deep: in the area of the basal nucleu, usually as a result of the rupture of smaller arteries caused by the effect of longtime exposure to high blood pressure.

Lobar: more in de elderly, far more superficial, caused by amyloid angiopathy

Question 7

What is a subarachnoid hemorrhage?

Answer 7

This type occurs in the space between the meninges surrounding the brain, mostly caused by a rupture (aneurysm) at or near the circlue of Willis.

SAH causes a sudden and extremely severe headache followed by neck stifness (some patients are traumatized by this)

Question 8

Where are the cognitive alterations mainly related to in a hemorrhage and an ischemia?

Answer 8

Hemorrhage: mainly the size and the secondary effects. When the hematoma has dissapeared, a bit of normal functioning may be restored.

Ischemia: here, location is of major importance.

Question 9

What are some disorders/problems that are most marked in left sided patients?

Answer 9

Cognitive:

• Mixed/global aphasia
• Transcortical aphasia
• (Ideomotor) apraxia
• Alexia
• Agraphia
• Acalculia
• Agnosia

Behavioral:

• Feel handicapped
• Behaving careful and cautious
• Catastrophic reactions
• Depression

Question 10

What are some disorders/problems that are most marked in right sided patients?

Answer 10

Cognitive:

• Agnosia
• Prosopagnosia
• Neglect
• Spatial/visuoconstructive disorders
• Aprosodia
• Problems with body perception

Behavioral:

• Social cognition
• Anosognosia
• Anosodiaphoria
• Impulsivity