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Acquired Brain Disorders

By definition, biological, directly traceable to the destruction of brain tissue or biochemical imbalances in the brain. Have a major effect on cognitive processes such as memory.

Problems in Diagnosis

1) deciding whether it is an ABD or a disease or a psychological disorder
2) the cause of the pathology
3) is the damage localised
4) how psychosocial factors influence the disorder's symptoms and whether medical treatment or psychological therapy can modify them.

Delirium

a transient, global disorder of cognition and attention. Delirious patients are profoundly confused; their thinking is disorganised, even dreamlike.
Emotional lability is common.
caused by widespread disruption of cerebral metabolism and neurotransmission. The cause is often intoxication from medication or surgery or withdrawal from alcohol/drugs.

Specific Cognitive Impairments

1. Impairment of attention and arousal
2. Impairment of language function
3. Impairment of learning and memory
4. Impairment of visual-perceptual function
5. Impairment of motor skills (apraxia - cannot perform well learnt movement)
6. Impairment of executive function or the ability to plan, initiate, sequence, monitor and stop complex behaviours.
7. Impairment of higher-order intellectual function.

Aphasia

inability to use or understand language (spoken or written) because of a brain lesion

Fluent Aphasia

aphasia characterized by fluent but meaningless speech and severe impairment of the ability understand spoken or written words

Nonfluent Aphasia

minimal speech activity with slow speech that requires obvious effort

Agnosia

is a term that means the inability to recognize familiar object. Usually occurs in one sensory domain.

Dementia

The impairment of at least two cognitive functions, resulting in a decline from a higher level of performance that compromises a person's occupational or social functioning.

Cerebral Infection

can be caused by bacteria, viruses, protozoa, or fungi.
There are three main categories of brain infection: cerebral abscess, encephalitis and meningitis.
Four specific infections: neurosyphilis, HIV, mad cow disease and Lyme disease.

Cerebral Abscess

infection that becomes encapsulated by connective tissue.
Brain abscesses usually occur from infection in another part of the body that travels to the brain or when a foreign object enters the brain, introducing germs.

Encephalitis

inflammation of the brain.
It is caused by the direct infection of the brain by viral, bacterial, parasitic or fungal agents.
epidemic encephalitis - sleeping sickness, prolonged lethargy, prolonged periods of sleep, often for days or weeks. During wakefullness - hyperactive, irritable and breathless and unable to sleep.
Other symptoms: convulsive seizures and delirium - often leads to death/sociopathic personality.

Meningitis

Another type of cerebral infection. It is an acute inflammation of the meninges, the membranous covering of the brain and spinal cord. It is caused by a bacterial infection that results because of an injury that penetrates the brain.
Symptoms: drowsiness, fever, headache, stiff neck, confusion, irritability, inability to concentrate, memory defects, and sensory impairments.

Neurosyphilis

The deterioration of brain tissue as a result of syphilis.

HIV Infection

Neuropsychological difficulties develop in 30 to 50% of individuals with HIV infection. - usually take the for of mild cognitive changes.
Serious cognitive impairment - HIV dementia

Mad Cow Disease

spongiform encephalopathies - mad cow disease.
First signs of infection - memory loss, confusion, behavioural change, and difficulty walking. As the disease progresses -> dementia. Death occurs about 4 months after the illness.

Lyme Disease

the most common tickborne disease. In the US, 15,000 cases a year.
Ticks get the disease by feeding on infected animal hosts.
When effects the CNS can lead to encephalitis or meningitis.

Traumatic Brain Injury

A result of jarring, bruising or cutting. The leading cause of disability and death in children and young adults.
The most serious cases lapse into a persistent vegetative state or develop epilepsy.
Common symptoms: fatigue, sleep disturbances, poor attention and concentration, slowed reactions, emotional ups and downs, and social and moral failures such as selfishness and callousness.
Subdivided into three categories: concussion, contusion and penetrating head injury,

Concussion

The blow to the head jars the brain, momentarily disrupting its functioning.
Usual result is a temporary loss of consciousness.
and typically unable to remember the events immediately preceding the injury.
The longer the person is unconscious, the more severe the post-traumatic symptoms.
The person may display apathy, depression, irritability, and various cognitive problems.

Contusion

the trauma is sever enough that the brain is not just jarred; it is actually bruised. The person lapses into a coma for several hours or even days and afterward may suffer convulsions and/or temporary speech loss.
Acute confusional state - experience hallucinations, delusions, agitation and a host of cognitive difficulties. This state is also know as delirium. Symptoms disappear after a week or so.
Repeated head injuries give repeated damage. (Dementia pugilistica or punch drunk syndrome - memory lapses, loss of coordination, dizziness, tremors and other psych impairments.

Cerebrovascular Accidents: Strokes

A blockage or breaking of the blood vessels in the brain results in injury to brain tissue.
Third leading cause of death in the US.
Two broad categoriesL infarction and hemorrhage.

Infarction

the supply of blood to the brain si somehow cut off, resulting in the death of brain tissue.
The two most common kinds are embolism and thrombosis.

Embolism

Type of infarction.
occlusion of a blood vessel by an embolus (a loose clot or air bubble or other particle)

Thrombosis

Type of infarction.
the formation or presence of a thrombus (a clot of coagulated blood attached at the site of its formation) in a blood vessel

Hemorrhage

Blood vessel in the brain ruptures, causing blood to spill out into the brain tissue. Usually traceable to hypertension - a sudden increase of blood pressus

The effects of a stroke

aphasia, agnosia, apraxia, and paralysis.
Depression is also a common response.
Emotional lability.
Half of first stroke patients die within 5 years usually from another stroke.

Metastatic brain tumours

Originate in a different part of the bosy and then metastasize, or spread, to the brain. Usually develop from cancer of the lung, breast, stomach or kidney.

Primary brain tumours

Originate in the brain.
Intracerebral - grow inside the brain tissue. (adults)
Extracerebral - grow outside the brain tissue. (children)

Degenerative Disorders

General deterioration of intellectual, emotional and motor functioning as a result of progressive pathological change in the brain.

Alzheimer's Disease

Autopsies reveal both neurofibrillary tangles and senile plaques.
Primary Symptoms: cog deficits, loss of memory for recent events.
Thought to be controlled in part by genes.

Lewy Body Disease

The disorder gets its name from the presence of microscopic rounded structures called Lewy bodies in neurons throughout the brain.
Followed by Parkinson's - may be genetically
linked to both Alz and Park
Day-to-day fluctuations in the patient's mental state. Hallucinations, confusion, agitation, and delusions come and go.

Vascular Dementia

cumulative effect of a number of small strokes of this kind, eventually impairing many of the brain's faculties.
physical signs: blackouts, heart problems, kidney failure, hypertension and retinal sclerosis.
common psych symptoms: language and memory deficits, emotional lability and depression. Psychosis might develop with delusions of persecution.

Frontotemporal Dementia

progressive deterioration of the frontal and temporal lobes of the brain.
Profound change in behaviour: disinhibited, easily distracted, socially inappropriate, and engage in purposeless overactivity. Increased talkativeness and sexuality and make tactless or offensive comments. Also emotional blunting.

Semantic Dementia

the ability to understand the meaning of words, faces, smells, tastes and tactile stimuli is progressively lost.

Progressive nonfluent aphasia

Characterized by language impairments, including struggles with speech and word retrieval.

Huntington's Chorea

transmitted genetically - passed by a dominant gene.
Basal Ganglia - clusters of nerve cell bodies deep within the cerebral hemispheres and responsible primarily for posture , muscle tonus and motor coordination.
Characteristic motor symptoms - an involuntary spasmodic jerking of the limbs.

Parkinson's Disease

Damage to the basal ganglia, the region - substantia nigra
Primary symptom: tremor, a rhythmic jerking of arms, hands, jaws, and/or head.
Problems with memory, learning, judgement, and concentration, as well as apathy and social withdrawal.
half develop dementia, delusions and severe depression.

Nutritional Deficiency

Malnutrition or insufficient intake of one or more essential vitamins - neurological damage and consequently in psychological disturbances

Korsakoff's psychosis

syndrome of anterograde and retrograde amnesia with confabulation (making up stories) associated with chronic abuse-often occurs together with Wernicke encephalopathy

Endocrine Disorders

Endocrine Glands are responsible for the production of hormones.
Thyroid syndromes, adrenal syndromes

Thyroid Syndromes

overactivity of the thyroid - hyperthryroidism or Draves' disease - excessive secretion of the hormone - severe apprehension and agitation, easy fatigability, excessive motor activity, sweating, anxiety.
hypothyroidism/myxedema - sluggish difficulties with memory and concentration, and appear to be lethargic and depressed.

Adrenal Syndrome

Underactivity - Addison's disease - depression, anxiety, irritability.
overactive - Cushing's syndrome - affects young women, emotional lability.

Lead encephalopathy

fluid accumulates in the brain, causing extreme pressure

Symptomatic epilepsy

Type of epilepsy that results from a known structural disease or etiology. Structural disease, such as malformations, tumors, and trauma, are usually apparent on neuroimaging.

Simple partial seizure

cognitive functioning remains intact. sensory changes

Complex partial seizure

interrupts cognitive function.

Generalized Seizures

Seizures that result from diffuse electrical activity that begins in one area of the brain and spreads to involve the entire cerebral cortex and brainstem

Absence Seizure

minor (petit mal) form of seizure, consisting of momentary clouding of consciousness and loss of awareness of surroundings

Tonic-Clonic seizures

seizures involving initial muscular contractions throughout the body progressing to alternating contracting and relaxation

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