WEEK 4 BRAIN INJURY

Question 1

What medications have good evidence for short term post-injury reduction of agitation?

Answer 1

Propranolol

Some evidence for antipsychotics, valpraote, amantadine, carbamazepine

Negative evidences for: nbenzos, opiates, psychostimulants and phenytoin

Question 2

What medications have good evidence for long-term management of aggression and agitation?

Answer 2

Carbamazepine and Valproate
Olanzapine (most useful acutely, may impair neuronal plasticity)
Some evidence for antidepressants even without overt mood disturbance.

Question 3

Apathy is particularly associated with damage to what brain area?

Answer 3

Anterior cingulate cortex

Question 4

What pharmacological interventions exist for apathy?

Answer 4

Dopamine agonists (amantadine)
Psychostimulants (methylphenidate)
antidepressants (agomelatine)

Question 5

What part of the brain in cerebellar cognitive affective syndrome associated with?

Answer 5

posterior lobes of cerebellum

deficits in emotional regulation, use of language, executive function, visuospatial function. Clinically can look very similar to damage to prefrontal cortex.