CHAPTER 7 TRAUMATIC AND CHRONIC BRAIN DAMAGE Clinical Neuroscience By Kelly Lambert and Craig Howard Kinsley
CHAPTER 7TRAUMATIC AND CHRONIC BRAIN
DAMAGE
Clinical Neuroscience
By Kelly Lambert and Craig Howard Kinsley
Chapter 7 Overview Review Concepts:
Brain imaging techniques (from Ch. 1)Neuroplasticity
Brain injuriesTraumatic Brain Injury (rapid onset)Chronic Brain damage (long-term onset)
For each injury, we’ll discuss:CausesEffectsTreatment methodsFuture Prospects
Lambert and Kinsley, Chapter 7 2
Connections
Traumatic Brain Injury (TBI) can strike anyoneBob Woodruff, ABC News
reporter, wounded in Iraq.
Recovery can be improved by a variety of factors:EducationEnriched environmentNeural reserves
Lambert and Kinsley, Chapter 7 3
Traumatic Brain InjuryCauses and Consequences Generally considered a result of impact to the skull
Other causes
Human cost:50,000-80,000 deaths annually235,000 hospitalizations annually~ 5 million Americans suffering lasting effects
Financial cost:$150,000 non-medical costsFatalities cost ~$450,000/case
Lambert and Kinsley, Chapter 7 4
Traumatic Brain InjuryWho’s at risk?
Individuals:15-24 years oldOver 64 years oldMenPeople consuming alcoholAthletes
Lambert and Kinsley, Chapter 7 5
Traumatic Brain InjuryEffects Primary
Axon ShearingSubdural hematomaEpidural hematomaContusion
Secondary EffectsIonic fluxHyperglycolysisEAAs
Lambert and Kinsley, Chapter 7 6
Traumatic Brain InjuryTreatments Glasgow Coma Scale
Initial assessment
Surgery Hematomas Depressed Skull fractures
Pharmacological Intervention Cognitive impairment
○ Dopamine○ Acetylcholine
Depression○ Serotonergic pathway
Lambert and Kinsley, Chapter 7 7
Traumatic Brain InjuryTreatments
Progesterone Therapy Don Stein’s work with mother rats
Cognitive Rehabilitation Yeshuda Ben-Yishay Holistic neuropsychological
rehabilitation program
Constraint-induced movement therapy
Environmental Enrichment General Enrichment Physical exercise Formal motor training
Lambert and Kinsley, Chapter 7 8
Traumatic Brain InjuryPrevention TBI is very common and preventable through:
1. Education
2. Enactment of safety laws
3. Enforcement of safety laws
Lambert and Kinsley, Chapter 7 9
Parkinson’s DiseaseCauses and Consequences Degeneration of the dopaminergic
pathways in the substantia nigra
Parellel deficits in other neurotransmitter pathwaysAcetylcholineSerotoninNorepinephrine
Lambert and Kinsley, Chapter 7 10
Parkinson’s DiseaseTreatments
SurgeryThalamotomyPallidotomy
Pharmacological interventionLevodopa (l-dopa)Decarboxylase inhibitor
Lambert and Kinsley, Chapter 7 11
Parkinson’s DiseaseTreatments/Future Directions Surgery (again!)
Deep Brain StimulationTransplantation of dopaminergic neurons (stem cells)
Neuroprotection?Identification of early symptomsTreatment before completely realized
Michael J. Fox Foundation
Lambert and Kinsley, Chapter 7 12
Summary
13Lambert and Kinsley, Chapter 7