Neurological disorders Flashcards
What is aquired brain injury?
(Drake et al 2015)
traumatic and other causes of brain injury such as stroke.
this is distinct from degenerative disorders of the brain which tend to be progressive.
What are the causes of traumatic brain injuries?
(Drake et al 2015)
- trauma to the head
- e.g. traffic accidents, assaults, falls
What is a mild brain injury?
- brief period of unconsciousness
- recovery is likley to be good and fast
- GCS 13-15
What is a moderate brain injury?
- loss of consciousness 15mins-6 hours
- recovery is often good however could have some residual disability
- GCS 9-12
What is a severe brain injury?
- unconsciousness over 6 hours
- very limited recovery
- GCS less than 9
What is a primary brain injury?
(Drake et al 2015)
- a closed head injury, no break of skin or wound
- head is rocked back and forth with brain following movement
- results in the nerve fibres twisting, stretching, and tearing
- most common type of injury
- Often happens as a result of rapid acceleration or deceleration e.g. car hitting a wall.
What is a diffuse brain injury?
(Drake et al 2015)
- a mild injury that produces damage widespread in the brain
- the front of the skull has sharp, bony, ridges where the brain collides, causing more damage.
- arteries and veins in the brain can be damaged causing blood to leak.
What happens in crushing injuries?
(Drake et al 2015)
- the head is caught between two hard objects
- the least common type of injury.
- often the damage is the base of the skull and nerves of the brain stem rather than the brain itself.
What is an anoxic brain injury?
(Drake et al 2015)
When the brain becomes starved of oxygen
- this makes damage from primary injuries worse
- may happen from choking, blood blocking airways, position someone is lying blocking their airway
What is a secondary brain injury?
(Drake et al 2015)
- takes place anytime after primary brain injury, may be days or weeks after
- due to bleeding, bruising, or swelling in the brain because blood clots have developed
- the skull cannot expand due to the fluids leading into the brain causing it to swell
- this means the brain is sqeezed against the skull, damaging it and limiting circulation
How are blood clots formed in the brain and what is their impact?
(Drake et al 2015)
- blood leaks from damaged veins and arteries and pools into a clot
- they can press on surrounding brain tissue which can damage it, and they also raise pressure in the brain.
- can occur in the brain itself or the space between the brain and the skull
What are the most visible signs of brain injury?
(Drake et al 2015)
- coma
- loss of power in the arms and legs
- speech impairment
- traumatic brain injury causes numerous ‘hidden disabilities’ in that it results in changes to personality, thinking and memory.
How do you reduce the risk of head injury?
(Drake et al 2015)
- ensure home is free of trip hazards
- childproof home
- use right safety equipment for work
- wear helmets
What is a stroke?
(Drake et al 2015)
an interruption of blood supply to area of brain, depriving it of oxygen and nutrients causing the cells to die
- two types, either a clot or a bleed
- ischemic stroke is the most common type, occuring when a blood clot prevents blood flow to the brain, accounts for 87% of strokes
- haemorrhagic stroke is when a blood vessel in the brain leaks or ruptures, causing the brain to swell and put pressure on brain cells, damaging them. can occur in the brain itself or in the subarachnoid space in the arteries
Give some statistics about stroke in the UK.
(Drake et al 2015)
- in 2019, 8% of all deaths in the UK were due to stroke
- there were 718,222 iindiviuals living with stroke in 2019
How is blood supplied to the brain?
(Drake et al 2015)
- comes from arterial circle at base of skull, made of the internal catotid and cerebral arteries
- the brainstem and cerebellum get their blood supply from branches off the basilar artery
- the cerbrum and cerbeal cortex get thier blood supply from the anterior, middle, and posterior cerebral arteries (ACA, MCA, PCA)
How are ischaemic strokes treated?
(Drake et al 2015)
- use of fibrinolytic drugs to break down the blood clot
- removal of the blood clot via a catheter based procedure requiring specialist resources
How are haemorrhagic strokes treated?
(Drake et al 2015)
- catheter based approaches, packing the aneurism
- surgical based approaches to clip the aneurism
What is BEFAST?
- stokes have different effects depending on the area of the brain however these are common signs
B- balance
E- eyes- blurry, double vision or loss of vision
F- facial drooping - or numbness
A- arm weakness
S-speech difficulty, slurred words, unable to speak
T- time to call 999
Early diagnosis and intervention lead to better outcomes
What mechanisms can cause neurodegeneration?
(Sience/AAAS, 2019)
- autophagy- breaks down and destruction of old, damaged or abnomal proteins
- oxidative stress- imbalance free radicals and antopxidants in the body causing damage
- apoptosis-programmed cell death
- necrosis- cell death
What is autophagy?
(Sience/AAAS, 2019)
normal housekeeping in cells, elimating waste and protecting against variations in nurtient availability
if disrupted toxic substances can accumulate, disruping cell function and causing harm
What is oxidative stress?
(Sience/AAAS, 2019)
when there is an inbalance btween the production of free radicals and the body’s ability to neutralize them with antioxidants.
free radicals are products of metabolic processes and are highly reactive molecules containing oxygen and can cause damage to the body
when there’s an excess of free radicals or a deficiency of antioxidants, oxidative stress can occur as the body cant neutralise them
What is apoptosis?
(Sience/AAAS, 2019)
- programmed cell death
- cells undergo a series of controlled biochemical changes that ultimately lead to their self-destruction.
- apoptosis is a controlled process that does not trigger inflammation or damage surrounding tissues, unlike other forms of cell death.
What is necrosis?
(Sience/AAAS, 2019)
a form of cell death that occurs as a result of injury, infection, or disease.
- Unlike apoptosis, which is a programmed and controlled process of cell death, necrosis is typically unplanned and unregulated.
