Brain Injury Part One
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| ischemic stroke is caused by | blockage
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| hemorrhagic stroke is caused by | bleeding
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| what is a lesion? | an area of damaged brain tissue
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| what does CVA stand for? | cerebrovascular accident
older term for stroke.
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| what is an infarct? | an area of dead or dying tissue due to an interruption of normal blood supply.
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| necrosis | irreversible process of cell death
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| brain attack | non-scientific term for stroke.
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| what is blood made of? | 55% water
the rest is: oxygen, nutrients like glucose, and red and white blood cells.
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| vascular system | system of blood supply and drainage.
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| what is the most important artery for blood supply to the language areas? | middle cerebral artery
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| 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.
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| anoxia | interrupted blood supply./ no oxygen
after 4-6 minutes causes irreversible cell damage.
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| what is the third leading cause of death in the united states? | stroke.
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| how many people that have a stroke are under the age of 65? | 28% of stroke patients are under that age.
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| 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.
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| what is the treatment for ischemic stroke? | "clot blusters", TPA= tissue plasminogen activator.
can only be used 3-6 hours within the attack.
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| 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.
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| what is the most common cause of hemorrhagic stroke? | aneurysm.
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| how do you treat a hemorrhagic stroke? | surgery! you suction the blood and fix the artery or put a clip on it.
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| 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).
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| during cell death, when do glial cells start to increase? | around seven days.
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| when does the majority of brain swelling occur in the process ofnecrosis? | around 4+ days.
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| what is the time course of necrosis? | 7 days - 3 months.
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| what happens during necrosis? | dead cells liquify
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| when does the cyst and/or scar tissue in the brain form? | 3-6 months.
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| 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.
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| how many new cases a year of aphasia? | 80, 000
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| aphasia is an _________ impairement of language following injury to the language areas of the brain | acquired
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| what is the most common cause of aphasia? | stroke
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| 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.
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| 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.
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| many aphasia begin as what? | global effects, but get kess severe with time.
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| why is the initial effect of a stroke so severe? | due to swelling.
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| what is common in all types of brain damage? | anomia
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| anomia | impaired ability to name objects.
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| verbal paraphasia/ semantic paraphasia | substitues one word for another.
dog for cat.
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| phonetic paraphasia | substitutes or OMITS obe sound from wors
og for dog or sog for dog.
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| neologism | substitutes a nonsense word for a real word.
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| perservation | repeats words or phrases inappropriately, like answers "yup" for every question asked.
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| agrammatic speech | speech is missing "function words" such as articles, aux verbs, conjunctions, prepositions.
in brocas area aphasia
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| 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.
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| what are 4 other problems with broca's aphasia? | 1. hemipareis
2. dysarthia
3. apraxia of speech
4. swallowing difficulties
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| hemiparesis | weakness and reduced sensation in the right side of the body.
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| dysarthia | slurred speech due to problems coordinating movements of the tongue, lips, cheeks and larynx.
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| apraxia of speech | problems with consistently sequencing the movements neccesary for speech
ERRORS ARE INCONSISTENT.
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| intonation and prosody are normal in what kind of aphasia? | werniches, not brocas.
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| 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.
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| what aphasia is rare in its severe form? | WERNICKES.
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| wernicke's aphasia usually resolves to what? | conduction aphasia is what it is resolved into
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| what is damaged in conduction aphasia? | arcuate fasciculus
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| 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.
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| 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.
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| what is the most important thing to remeber in the two transcrotica laphasias? | ABILITY TO REPEAT ONLY.
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| transcortical motor aphasia | similar to brocas area aphasia
but able to repeat
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| transcortical sensory aphasia | similar to wernickes apahsia
but able to repeat
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| 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.
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| anomia comes from damage in what areas? | can result from damage in many different areas BUT primarily in:
left temporal/ pareital lobes.
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| what is: non fluent poor repetion poor comprehension | global aphasia
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| what is: poor comphrehension fluenty poor repeition | wernickes
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| what is: poor comphrehension fluen good repetiton | transcortical sensory aphasia
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| what is: non-fluient\ good comprehension poor repetion | brocas
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| what is: poor repetiion good comprehension fluent | conduction aphasia
horrible short term memory.
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| what is: non fluent good comprehension good repetion | transcortical motor aphasia
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| how do you verify a tumor? | CT or MRI
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| edema | brain swelling, tumor.
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| alexia without agraphia | you can write but you cant read what you wrote.
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| 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.
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| 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.
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| 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.
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| what is the main type of stroke in kids? | hemorrhagic due to artervenious malformation, subcortical strokes.
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| circumlocations | to talk around something, to describe it instead of just naming it. "that furry, round thing".
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| why are laterality effects not as clear cut in children as in adults? | because laterality develops over time.
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| in a right hemisphere lesion, what happens to language? | impaired semantics and pragmatic knowledge.
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| in a left hemisphere lesion, what happens to language? | impaired syntax and pragmatics, and interaction of syntax and pragmatics.
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| when children have a stroke, how does it effect their IQ? | doesnt.
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| 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).
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| 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.
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| landau-kleffener syndrome | progressive loss of language accom[pied by convolusive/seizure disorder.
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| what factor does age have to play in the severity of landua-kleffener syndrome? | the younger the child is; the more severe.
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| how often do seizures occur in landau-kleffener patients? | 70-75%.
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| 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.
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| what is the normal age of landau kleffner patients? (50%) | ages 3-8
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| what do landau-kleffner patients who get it after the age of nine usually get? | consideed late onset.
expressive aphasia with anomia.
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| what is the male to female ratio in landau-kleffners? | male:female 2:1 for that disease.
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| 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.
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| 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.
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| what are the behavior problems in landau-kleffner patients? | they are usually severe;
hyperactivity
impusivity
oppositional behavior.
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| 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.
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| 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.
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| 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.
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| 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.
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| lexical retrival | retriving words and maintaining language appropriately depeoinding on the listener.
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| what is the most common and frustrating impairement in biolingual aphasia? | lexical retrival.
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| what is language retrival mainly affected by? | language proficency.
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| 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.
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| should therapy be conducted in the person's most profienct language? why? | no nbecause using the less proficent language will lead to generalization.
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| what is the best time to administer treatment to stroke patients? | o-3 months after the stroke.
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