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Neurological Disorders
Tumors - 24,000/yr
Cerebrovascular Accidents - 500,000/yr
Seizure Disorders - 2,000,000 in US
Traumatic Brain Injury - 1/1000 - 50,000 die/yr
Infectious Diseases
Degenerative Disorders
Types of Tumors
Malignant - cancerous = infiltratingBenign - noninfiltrating (encapsulated)
Gliomas (60%)Glioblastoma - worstAstrocytoma (70%)(same etiology - just severity really)
Meningioma
Metastatic carcinoma (35%)- skin, lung, breast, prostrate
Treatment - neuro-oncology
Surgerycraniotomy
Radiosurgery(radiation treatment)- goal - tumor only
Chemotherapy (less in brain cases)- drugs taken up my tumor cells- blood-brain barrier
Stroke - cerebrovascular accidents
Ischemic (80%)thrombus - 50%embolus - 30%
TIA
infarct
Hemorrhage (20%)intracerebral - 14%subarachnoid - 6%
hypertension, aneurism, AVM
Stroke - cerebrovascular accidents
The glutamate cascade (ischemic cascade)-anoxia - starving or flood with blood- release glutamate- stimululate - calcium enters
mitochondria - iron released??oxygen free-radicals
Treatments - prevent or in acute phase-antithrombotic - aspirin-anticoagulants - warfarin, heparin- thrombolytic - tissue plasminogen activator (t-PA)-calcium antagonist-glutamate antagonist
Psychoactive Drugs
Psychedelics Phencyclidine - PCP or angel dust
- ketamine is similar- analgesic- amnesiac- anesthestic (powerful)
- NMDA receptor - antagonistvery good amnesiac
- prevent Ca influx and cell death from stroke?
Rostral
Anterior cerebral arteryInternal carotid artery
Temporal lobePituitary gland
Pons
Medulla
Cerebellum
caudal
Olfactory bulb
Optic nerves (cut off)
Middle cerebral artery
End of temporal lobe removed
Mammiliary bodies
Posterior cerebral artery
Basilar artery
Vertebral artery
Each of the three major arteries of the cerebral hemispheres-the anterior, middle, and posterior- provides blood to a different region of the cerebrum.
Atropine Injectors
Why is this relevant? (war, nerve gas??)
Atropine - anticholineric - blocks Ach receptors- competitive inhibitor- more muscarinic than nicotinic
Counters Nerve Gases - Sarin, Soman, VX- irreversible AchE inhibitors - organophosphates (1800’s)- like malathion - insects
(mammals inactivate the drug)
Atropine Injectors
Nerve Gas
- Ach accumulates - autonomic (parasym) - all faucets on- somatic - twitch & contractions, weakness- brain - anxiety, confusion, ataxia, seizures
Death- continual depolarization of diaphram- die due to respiratory failure- also cardiac arrest
- Pralidoxime treatment - fixes AchE
Seizure Disorders
GeneralizedTonic-clonic (grand mal)Absence (petit mal)Atonic (loss of muscle tone)
PartialSimple (normal consciousness)
localized (partial) motorMotor seizureSensoryPsychicAutonomic
Complex (altered conciousness)automatisms
Seizure Disorders
GeneralizedTonic-clonic (grand mal)Absence (petit mal)Atonic (loss of muscle tone)
PartialSimple (normal consciousness)
localized (partial) motorMotor seizureSensoryPsychicAutonomic
Complex (altered conciousness)
Seizure Disorders
GeneralizedTonic-clonic (grand mal)Absence (petit mal)Atonic (loss of muscle tone)
PartialSimple (normal consciousness)
localized (partial) motorMotor seizureSensoryPsychicAutonomic
Complex (altered conciousness)automatisms
Seizure Disorders
Daiagnosisbrain imaging (MRI)electrical recording (EEG)
TreatmentVariety of Drugs
Anticonvulsants (Dilantin, Tegretol)
Surgery- map- record- cut
Neurological Disorders
Tumors - 24,000/yr
Cerebrovascular Accidents - 500,000/yr
Seizure Disorders - 2,000,000 in US
Traumatic Brain Injury - 1/1000 - 50,000 die/yr
Degenerative Disorders
Infectious Diseases
Degenerative Diseases
Parkinson’s Disease - 500,000 folksdegeneration of dopamine neurons from S.N.- pesticides/toxins- destroy mitochondrial complex 1 (enzyme)- rotenone - affects all, kills dopamine neurons (rats)
Huntington’s Chorea (heredity - chromosome 4) - 30,000- degeneration of putatmen and caudate nucleus (N.O. ?)- lose inhibitory control
Multiple Sclerosis - 350,000- autoimmune demyelinating disease
Alzheimer’s Disease (linked to Ach neurons)- dementia- neuritic plaques (beta amyloid) & neurofibrillary tangles
Infectious Diseases
EncephalitisViral infectionArboviruses (insects)Herpes SimplexpoliomyelitisRabiesAIDS - toxoplamosis - protozoa parasite“Prion” Diseases (proteinaceous infectious partic.)
Spongiform EncephalopathiesCreutzfeldt-JakobKuru
Meningitisviral - usually not badbacterial - can be bad
- Hib vacine in kids
Animal Models of Human Neuropsychological Disease
Animals - easier way to study
Kindling Model - Epilepsy- repeated elect stim to amygdala- long lived changes- distributed, not massed, stimulation
Transagenic Mice - AD- develop plaques (but not tangles)
MPTP - for parkinson’s- metabolized into MPP+- kills DA neurons & Deprenyl blocks it
Neural Degeneration- anterograde - distal part- proximal - towards cell body
Neural Regeneration- not great- a little in PNS - guided by Schwann cells- how much guidance determines outcome
Neural Reorganization- yes, it happens, big area of work- mostly sensory & motor- even new neurons - hippocampus
Recovery after brain damage
- neural function - not a lot really
- reduced edema & swelling- when cells die they are gone
- learn new strategies- e.g., new path to old end point- cognitive reserve