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