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SPA 2109: week 3

Brain Injury Part One

ischemic stroke is caused by blockage
hemorrhagic stroke is caused by bleeding
what is a lesion? an area of damaged brain tissue
what does CVA stand for? cerebrovascular accident older term for stroke.
what is an infarct? an area of dead or dying tissue due to an interruption of normal blood supply.
necrosis irreversible process of cell death
brain attack non-scientific term for stroke.
what is blood made of? 55% water the rest is: oxygen, nutrients like glucose, and red and white blood cells.
vascular system system of blood supply and drainage.
what is the most important artery for blood supply to the language areas? middle cerebral artery
hypoxia reduced blood supply/ reduced oxygen. symptoms are confusion and fainting. if it continues for a long time then it causes irreversible cell death and damage. examples: drowning, stranglation, stroke.
anoxia interrupted blood supply./ no oxygen after 4-6 minutes causes irreversible cell damage.
what is the third leading cause of death in the united states? stroke.
how many people that have a stroke are under the age of 65? 28% of stroke patients are under that age.
explain the two types of ischemic stroke. thromboltic and embolic. thrombosis is a clot that forms within the brain and embolic is a clot that travels from another place in the body into the brain and causes a blockage.
what is the treatment for ischemic stroke? "clot blusters", TPA= tissue plasminogen activator. can only be used 3-6 hours within the attack.
what is a TIA? transcient schemic attack. mini stroke. symtoms of stroke that disappear quickly. should still go to the hospital, large sign of an oncoming real stroke.
what is the most common cause of hemorrhagic stroke? aneurysm.
how do you treat a hemorrhagic stroke? surgery! you suction the blood and fix the artery or put a clip on it.
arteriovenous malformation (AVM) congential weakeness in the brain's circulary system that causes the brain's veins and arteries to tangle together. these tangled areas can rupture over time and bleed into the brain (hemorrhage).
during cell death, when do glial cells start to increase? around seven days.
when does the majority of brain swelling occur in the process ofnecrosis? around 4+ days.
what is the time course of necrosis? 7 days - 3 months.
what happens during necrosis? dead cells liquify
when does the cyst and/or scar tissue in the brain form? 3-6 months.
difference between cyst, scar tissue, and area oif central infarct cyst is the hole in the brain due to damage. scar tissue if the hole is only small. and area of infarct is the dead/dying area around the cyst itself.
how many new cases a year of aphasia? 80, 000
aphasia is an _________ impairement of language following injury to the language areas of the brain acquired
what is the most common cause of aphasia? stroke
what kind of aphasia will result with the damage in the upper part of the middle cerebral artery? will cause frontal lesion/ anterior damage therefore it is a NON-FLUENT APHASIA.
what kind of apahsia will result with the damage in the lower part of of the middle cerebral artery? leads to posterior damage therefore FLUENT APHASIA.
many aphasia begin as what? global effects, but get kess severe with time.
why is the initial effect of a stroke so severe? due to swelling.
what is common in all types of brain damage? anomia
anomia impaired ability to name objects.
verbal paraphasia/ semantic paraphasia substitues one word for another. dog for cat.
phonetic paraphasia substitutes or OMITS obe sound from wors og for dog or sog for dog.
neologism substitutes a nonsense word for a real word.
perservation repeats words or phrases inappropriately, like answers "yup" for every question asked.
agrammatic speech speech is missing "function words" such as articles, aux verbs, conjunctions, prepositions. in brocas area aphasia
agrammatic comprehension not just in brocas aphasia. means there is a difficulty with reversible passives (the leopard killed the lion) and sequences (my father's sister). basically cant understand how the words relate to one another.
what are 4 other problems with broca's aphasia? 1. hemipareis 2. dysarthia 3. apraxia of speech 4. swallowing difficulties
hemiparesis weakness and reduced sensation in the right side of the body.
dysarthia slurred speech due to problems coordinating movements of the tongue, lips, cheeks and larynx.
apraxia of speech problems with consistently sequencing the movements neccesary for speech ERRORS ARE INCONSISTENT.
intonation and prosody are normal in what kind of aphasia? werniches, not brocas.
explain the effects of writing in wernickes patients writing makes no sense much like their speech. but can read out loud most of the time.
what aphasia is rare in its severe form? WERNICKES.
wernicke's aphasia usually resolves to what? conduction aphasia is what it is resolved into
what is damaged in conduction aphasia? arcuate fasciculus
what is the major impairement in conduction aphasia? REPETITION both comprehension and speech is fluent because both brocas and wernickes remain intact, but the connection between them is bad.
what does conduction aphasia cause? phonetic paraphasias, television for velitision realizes it but tried to correct it many times ,sometoimes still unable to get it right.
what is the most important thing to remeber in the two transcrotica laphasias? ABILITY TO REPEAT ONLY.
transcortical motor aphasia similar to brocas area aphasia but able to repeat
transcortical sensory aphasia similar to wernickes apahsia but able to repeat
what does global aphasia come from? large lesions in the perisylvian area including brocas and wernickes and arcuiate fascoilious. almost always resolves to severe brocas or wernickes. patients are often mute or use vocal repetions.
anomia comes from damage in what areas? can result from damage in many different areas BUT primarily in: left temporal/ pareital lobes.
what is: non fluent poor repetion poor comprehension global aphasia
what is: poor comphrehension fluenty poor repeition wernickes
what is: poor comphrehension fluen good repetiton transcortical sensory aphasia
what is: non-fluient\ good comprehension poor repetion brocas
what is: poor repetiion good comprehension fluent conduction aphasia horrible short term memory.
what is: non fluent good comprehension good repetion transcortical motor aphasia
how do you verify a tumor? CT or MRI
edema brain swelling, tumor.
alexia without agraphia you can write but you cant read what you wrote.
how does time of brain injury matter for children? -reading and writing will be imparied if not mastered before injury. -more complex language does not recover well. -PRAGMATICS AND THEORY OF MIND HAPPEN WITH EARLIER TIME OF INJURY -it requires a lot of executive function to hold two concepts in mind.
what are the three main causes of TBI in children? 1. car accident 2. abuse 3. shaken baby syndrome are the main causes of it.
what age of injury affects things such as language coimprehension, metalinguistic awareness, facial expression, reading/writing etc? injury before the age of seven causes this.
what is the main type of stroke in kids? hemorrhagic due to artervenious malformation, subcortical strokes.
circumlocations to talk around something, to describe it instead of just naming it. "that furry, round thing".
why are laterality effects not as clear cut in children as in adults? because laterality develops over time.
in a right hemisphere lesion, what happens to language? impaired semantics and pragmatic knowledge.
in a left hemisphere lesion, what happens to language? impaired syntax and pragmatics, and interaction of syntax and pragmatics.
when children have a stroke, how does it effect their IQ? doesnt.
what is mainly effected by children who have a stroke? 4things. impaired short term memory attention alertness impulsivity they are also less independent, and have problems with social relations (parents, peers).
in a child with a stroke, what is most effected; visuo-spatial abilities or verbal abilities? regardless of the hemisphere of damage, verbal is always more preserved.
landau-kleffener syndrome progressive loss of language accom[pied by convolusive/seizure disorder.
what factor does age have to play in the severity of landua-kleffener syndrome? the younger the child is; the more severe.
how often do seizures occur in landau-kleffener patients? 70-75%.
what is a possible explanation for landau-kleffner syndrome? result of a low=-grade viral infection that affects myelin and or arteries of the brain.
what is the normal age of landau kleffner patients? (50%) ages 3-8
what do landau-kleffner patients who get it after the age of nine usually get? consideed late onset. expressive aphasia with anomia.
what is the male to female ratio in landau-kleffners? male:female 2:1 for that disease.
how long does impairment in landau- kleffener's patients usually last for? sometimes for months or years; cn be PERMANANENT. no way to predict it; happens randomnly.
what is the long-term outcome for language and for seizures? long twerm outcome for lanmguage is poor; and if EEG abnoramlities continue, then it is unlikely that language will ever recover to a normal level. seizures on the other hand usually resolve themselves by the time adulthood comes around.
what are the behavior problems in landau-kleffner patients? they are usually severe; hyperactivity impusivity oppositional behavior.
what happens to nonverbal intellgenice in landau-kleffner patients? nonverbal intellegince is preserved in this type of syndrome; which means it is primarily left hemisphere damage.
in landau-kleffener's, what is more impraired, oral or written? in this syndrome, oral is more impraired then written. meaning that there is a sever comprehension imprairement.
verbal auditory agnosia complete non-recognition of words and environmental sounds. such as they cant tell the difference between a bird chirping and a word. happens in landau-kleffners syndrome.
how will grammar be effected depeinding on damage in L1 or L2? if damage in the frontal/basal ganglia, then L1 grammar impaired. if damage in the left temporal/parital lobe, then L@ more affected.
lexical retrival retriving words and maintaining language appropriately depeoinding on the listener.
what is the most common and frustrating impairement in biolingual aphasia? lexical retrival.
what is language retrival mainly affected by? language proficency.
what are two exmaples/evidence for shared conceptual/semantic system? 1. biliguals often remember concepts and not the language thta the concept was presented in. 2. in a study, bilinguals were twice as likely to forget which language the item was presented in instead of the item itself.
should therapy be conducted in the person's most profienct language? why? no nbecause using the less proficent language will lead to generalization.
what is the best time to administer treatment to stroke patients? o-3 months after the stroke.
Created by: pandaxx