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SPA 2109: week 3
Brain Injury Part One
Question | Answer |
---|---|
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. |