NEUROPSYCHOLOGY & BEHAVIORAL NEUROSCIENCE
C J Long
Overview of Topics
Traumatic Brain Injuries
The primary source for this section should be a neurology text. I have used Merritt A Textbook in Neurology. See reference section.
- Behavior Patterns of CNS disease
- Course of Illness
- Organic vs functional Relationships
- Disease processes
- Intrinsic neoplastic processes
- Occlusive disorder
- Head Trauma
- Infections Diseases
- Genetic factors
Neurons are dependent upon oxygen and glucose provided by the circulatory system to function. If the blood supply is interrupted over 10 minutes, they die.
Blood supply from:
- 2 internal carotid
- anterior cerebral artery - anterior cortex & midline
- middle cerebral artery - middle cortex
- 2 vertebral arteries
- Basilar Artery
- Posterior cerebral artery - infero-temporal, posterior occipital
- Circle of Willis
- Anterior communicating artery
- Posterior communicating artery
Symptoms of vascular disorders
Factors affecting symptoms
- Size of vessel
- Health of remaining vessels
- Location of area
- Extent of occlusion
- Presence of anastomoses
Types of Vascular Disorders
- Cerebral Ischemia
- Thrombosis - blockage due to clot
- Embolism - other type of blockage
- Cerebral arteriosclerosis - constricted flow
- Ischemia due to N-methyl-D-aspartate receptor overstimulation. Receptors may be important in learning but if overstimulated are self-destructive.
- Migraine Stroke
- Classic migraine - transient ischemic attack. Reoccurrence can lead to infarct
- Cerebral Hemorrhage
- Often associated with hypertension.
- Angiomas & Aneurysms
- Angiomas (AV malformations) - congenital collections of abnormal vessels
- Aneurysms - vascular dilaions due to ballooning of vessel wall.
Traumatic Brain Injuries
Leading cause of death between 4 and 44 years of age.
- Penetrating Head Injuries
- Contusion - bruse of brain, focal.
- No loss of consciousness
- Risk of infection & seizure is high.
- Closed Head Injuries
- Mechanical force to moble head causes shear forces.
- Centrifugal effects from cortex to brain stem.
- More severe - loss of consciousness.
- Symptomatic - reflect abnormal EEG activity due to underlying disorder.
- Idopathic - due to some unknown condition.
- Focal seizures - begin locally & spread (Jacksonian seizures)
- Complex partial seizures - most common in temporal lobe.
- Subjective feelings
- Generalized seizures
- Grand Mal - significant motor involvement
- Petit mal or absence - little motor & brief.
- Autokinetic - sudden collapse, seen in children.
- Myoclonic spasms - massive seizures
- Gliomas - 45% of all
- Astrocytomas - slow (40%), over 30 years of age.
- Gliobastomas - highly malignant (30%), over 35 years of age.
- Medullobastomas - highly malignant (11%), cerebellum of children.
- Meningiomas - Extrinsic tumors
- Metastatic Tumors - spread from other source.
- Other Tumors - pituitary adenoma.
- Migraine - 5-20% of population
- Familial disorder, commonly unilateral
- Classic migraine - 12% of sufferers
- lasts 20-40 minutes.
- has aura associated with vascular constriction
- Common migraine - 80%, no aura
- Cluster headache - episodic & intense.
- Can be associated with disease but most are not.
Encephalitis - inflammation of CNS (viral, bacterial, fungal, parasitic.)
- Alzheimer’s Disease - accounts for 65% of dementia characterized by neurofibrils and plaques
- Pick’s Disease
- Cruetzfeldt-Jacob’s disease
- Korsakoff’s syndrome
- Huntington’s Chores
- Parkinson’s disease
- Multiple Sclerosis
- Myasthenia Gravis