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


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


Traumatic Brain InjuryWho’s at risk?

Individuals:15-24 years oldOver 64 years oldMenPeople consuming alcoholAthletes


Traumatic Brain InjuryEffects Primary

Axon ShearingSubdural hematomaEpidural hematomaContusion

Secondary EffectsIonic fluxHyperglycolysisEAAs


Traumatic Brain InjuryTreatments Glasgow Coma Scale

Initial assessment

Surgery Hematomas Depressed Skull fractures

Pharmacological Intervention Cognitive impairment

○ Dopamine○ Acetylcholine

Depression○ Serotonergic pathway


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


Traumatic Brain InjuryPrevention TBI is very common and preventable through:

1. Education

2. Enactment of safety laws

3. Enforcement of safety laws


Parkinson’s DiseaseCauses and Consequences Degeneration of the dopaminergic

pathways in the substantia nigra

Parellel deficits in other neurotransmitter pathwaysAcetylcholineSerotoninNorepinephrine


Parkinson’s DiseaseTreatments

SurgeryThalamotomyPallidotomy

Pharmacological interventionLevodopa (l-dopa)Decarboxylase inhibitor


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


Summary

13Lambert and Kinsley, Chapter 7

clinical neuroscience by kelly lambert and craig howard kinsley

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