Brain Damage

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 Causes of Brain Damage
• Brain tumors
• Cerebrovascular disorders
• Closed-head injuries
• Infections of the brain
• Neurotoxins
• Genetic factors

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 (1) Brain Tumors
• A tumor (neoplasm) is a mass of cells that grows
independently of the rest of the body – a cancer
• About 20% of brain tumors are meningiomas –
(Tumors that grow between the meninges)
– Encapsulated tumors, growing within their own
membranes
– they can influence the function of the brain only by
the pressure they exert on surrounding tissue
– Usually benign, surgically removable with little risk of
further growth in the body

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 (1) Brain Tumors Continued
• Most brain tumors are infiltrating tumors
– Grow diffusely through surrounding tissue
– Malignant, difficult to remove or destroy
completely and any cancerous tissue that
remains after surgery continues to grow.
• About 10% of brain tumors are metastatic –
they do not originate in the brain, they
originate elsewhere, usually the lungs

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 (2) Cerebrovascular Disorders
• Stroke – a sudden-onset cerebrovascular event that causes brain damage.
• The symptoms of a stroke depend on the area of the brain that is affected, but
common consequences of stroke are amnesia, aphasia (language difficulties),
paralysis, and coma.
• There are two major types of strokes, those resulting from:
– Cerebral hemorrhage – bleeding in the brain
– Cerebral ischemia – disruption of blood supply
• Stroke is the third leading cause of death in the U.S. and most common cause of
adult disability

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 (2) Cerebrovascular Disorders
Continued
• Cerebral Hemorrhage – occurs when a
cerebral blood vessel ruptures and blood
seeps into the surrounding neural tissue and
damages it.

– Aneurysm – enlargement of the artery

caused by a weakening in the artery wall, a
weakened point in a blood vessel that
makes a stroke more likely; may be
congenital (present at birth) or due to
poison or infection

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 (2) Cerebrovascular Disorders
Continued
• Cerebral Ischemia – disruption of blood supply to an
area of the brain.
• Three main causes are:
– Thrombosis – a plug forms in the brain and blocks the
blood flow
– Embolism – a plug forms elsewhere and moves to the
brain
– Arteriosclerosis – wall of blood vessels thicken, and
the channels narrow usually, due to fat deposits, this
narrowing can eventually lead to complete blockage
of the blood vessels

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 (3) Closed-Head Injuries
• Brain injuries due to blows that do not
penetrate the skull – the brain collides with
the skull
• Contusions – are closed-head injuries that
involve damage to the cerebral circulatory
system. Such damage produces internal
hemorrhaging, which results in a hematoma.
– A hematoma is a localized collection of clotted
blood in an organ or tissue in other words, a
bruise.

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 (3) Closed-Head Injuries
• It may surprise you to learn that contusions
frequently occur on the side of the brain opposite
the side struck by a blow. This is called contrecoup
injuries.
The reason for such is that the blow causes
the brain to strike the inside of the skull on the
other side of the head.

• When there is a disturbance of consciousness

following a blow to the head and there is no
evidence of a contusion or other structural
damage, the diagnosis is concussion
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 (3) Closed-Head Injuries
Continued
• While there is no apparent brain damage
with a single concussion, multiple
concussions may result in a dementia
referred to as “punch-drunk syndrome”.
– Dementia - general intellectual deterioration

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 (4) Infections of the Brain
• An invasion of the brain by microorganisms is a
brain infection.
• Encephalitis – the resulting inflammation of the
brain because of brain infection.
• There are two common types of brain infections:
Bacterial Infections and Viral Infections
– Bacterial infections
• Often lead to abscesses, pockets of pus
• May inflame meninges, creating meningitis
• Treated with penicillin and other antibiotics but they cannot
reverse brain damage that has already been produced.

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 (4) Infections of the Brain
– Bacterial infections
• Syphilis
• Syphilis bacteria are passed from infected to
noninfected individuals through contact with genital
sores. The infecting bacteria then go into a dormant
stage for several years before they become virulent
and attack many parts of the body, including the
brain.
• The syndrome of insanity and dementia that results
from a syphilitic infection is called general paresis.

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 (4) Infections of the Brain
• Viral Infections There are two types of viral infections of
the nervous system:
– Those that have a particular affinity for neural tissue;
– Those that attack neural tissue but have no greater affinity for it than
for other tissues.
• Rabies, is a well-known example of a virus that has a
particular affinity for the nervous system. Although the
effects of the rabies virus on the brain are almost always
lethal (Willoughby, 2007), the virus does have one
redeeming feature: It does not usually attack the brain
for at least a month after it has been contracted, thus
allowing time for a preventive vaccination.

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 (4) Infections of the Brain
• Viral Infections:

• The mumps and herpes viruses are common

examples of viruses that can attack the
nervous system but have no special affinity for
it.
• Although these viruses sometimes spread into
the brain, they typically attack other tissues of
the body.

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 (5) Neurotoxins
• The nervous system can be damaged by
exposure to any one of a variety of toxic
chemicals, which can enter general circulation
from the gastrointestinal tract, from the
lungs, or through the skin.

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 (6) Genetic Factors
• Normal human cells have 23 pairs of
chromosomes; however, sometimes accidents
of cell division occur, and the fertilized egg
ends up with an abnormal chromosome or
with an abnormal number of normal
chromosomes. Then, as the fertilized egg
divides and re-divides, these chromosomal
anomalies are duplicated in every cell of the
body.

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 Programmed Cell Death
• All six causes of brain damage produce
damage, in part,. by activating apoptosis

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 Neuropsychological Diseases

• Epilepsy
• Parkinson’s disease
• Huntington’s disease
• Multiple sclerosis
• Alzheimer’s disease

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 Epilepsy
• Primary symptom is seizures (sudden
surge of electrical activity in the brain),
but not all who have seizures have epilepsy
• Epileptics have seizures generated by their
own brain dysfunction
• Affects about 1% of the population
• Difficult to diagnose due to the diversity
and complexity of epileptic seizures
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 Epilepsy Continued
• Types of seizures
– Convulsions – motor seizures
– Some are merely subtle changes of thought,
mood, or behavior
• Causes
– Brain damage
• Diagnosis
– EEG – electroencephalogram
– Seizures associated with high amplitude
spikes
`

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 Epilepsy Continued
• Seizures often preceded by an aura, such as a
smell, hallucination, or feeling
– Aura’s nature suggests the epileptic focus
– Warns epileptic of an impending seizure
Two general categories:
• Partial epilepsy – does not involve the whole
brain
• Generalized epilepsy – involves the entire
brain
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 Partial Seizures
• Simple
– Symptoms are primarily sensory or motor or
both (Jacksonian seizures)
– Symptoms spread as epileptic discharge spreads
• Complex
– Often restricted to the temporal lobes
(temporal lobe epilepsy)
– Patient engages in compulsive and repetitive
simple behaviors (automatisms)
– More complex behaviors seem normal

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 Generalized Seizures
• Grand mal
– Loss of consciousness and equilibrium
– Tonic-clonic convulsions
• Rigidity (tonus)
• Tremors (clonus)
– Tongue biting, urinary incontinence, and cyanosis (turning blue from excessive
extraction of oxygen from the blood during the convulsion) are common
manifestations of grand mal convulsions. The hypoxia (shortage of oxygen
supply to tissue, for example, to the brain) that accompanies a grand mal
seizure can itself cause brain damage.

• Petit mal
– Not associated with convulsions
– A disruption of consciousness associated with a cessation of ongoing behavior

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 Parkinson’s Disease
• A movement disorder of middle and old age
affecting about .5% of the population
• It is about 2.5 times more prevalent in males
than in females (see Lorincz, 2006).
• The initial symptoms of Parkinson s disease
are mild perhaps no more than a slight
stiffness or tremor of the fingers but they
inevitably increase in severity with advancing
years.

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 Parkinson’s Disease Continued
• Like epilepsy, Parkinson s disease seems to have no single cause;
faulty genes, brain infections, strokes, tumors, traumatic brain injury,
and neurotoxins have all been implicated in specific cases.
• However, in the majority of cases, no cause is obvious, and there is
no family history of the disorder.
• One of the most controversial treatments for Parkinson’s disease is
deep brain stimulation, a treatment in which low-intensity electrical
stimulation is continually applied to an area of the brain through a
stereotaxically implanted electrode

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 Huntington’s Disease
• Like Parkinson’s disease, Huntington s disease is a progressive motor
disorder of middle and old age;
• but, unlike Parkinson’s disease, it is rare (1 in 10,000), it has a strong
genetic basis, and it is associated with severe dementia.
• The first sign of Huntingtons disease is often increased fidgetiness. As
the disorder develops, rapid, complex, jerky movements of entire limbs
(rather than individual muscles) begin to predominate.
• Eventually, motor and intellectual deterioration become so severe that
sufferers are incapable of feeding themselves, controlling their bowels,
or recognizing their own children.
• There is no cure; death typically occurs about 15 years after the
appearance of the first symptoms.

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 Huntington’s Disease
• Eventually, motor and intellectual deterioration become
so severe that sufferers are incapable of feeding
themselves, controlling their bowels, or recognizing their
own children.

• There is no cure; death typically occurs about 15 years

after the appearance of the first symptoms.

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 Huntington’s Disease
• Huntingtons disease is passed from generation to
generation by a single dominant gene, called huntingtin.
• The protein it codes for is known as the huntingtin
protein. Because the gene is dominant, all individuals
carrying the gene develop the disorder, as do about half
their offspring.
• The Huntington’s gene is often passed from parent to
child because the first symptoms of the disease do not
appear until after the peak reproductive years (at about
age 40).

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 Multiple Sclerosis
• Multiple sclerosis (MS) is a progressive disease
that attacks the myelin of axons in the CNS.
• It is particularly disturbing because it typically
attacks young people just as they are beginning
their adult life.
• First, there are microscopic areas of degeneration
on myelin sheaths; but eventually damage to the
myelin is so severe that the associated axons
become dysfunctional and degenerate.
• Ultimately, many areas of hard scar tissue
develop in the CNS (sclerosis means hardening ).
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 Multiple Sclerosis Continued
• In some cases, there are periods of remission
(up to 2 years), during which the patient
seems almost normal; however, these are
usually just oases in the progression of the
disorder, which eventually becomes
continuous and severe.
• Common symptoms of advanced multiple
sclerosis are visual disturbances, muscular
weakness, numbness, tremor, and ataxia
(loss of motor coordination). In addition,
cognitive deficits and emotional changes
occur in some patients.
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 Multiple Sclerosis Continued
• Epidemiological studies of multiple sclerosis have
provided evidence of both genetic and
environmental factors in its etiology .
• + incidence is higher among populations living in
colder climates, as opposed to near the equator;
• + individuals who migrate from a high-incidence
region to a low-incidence region, particularly at a
young age, reduce their susceptibility (and vice
versa); and
• + cigarette smokers are at greater risk.
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 Alzheimer’s Disease
• Alzheimer s disease is the most common cause of
dementia.
• It sometimes appears in individuals as young as 40, but
the likelihood of its development becomes greater with
advancing years.
• Alzheimer s disease is progressive.
• Its early stages are often characterized by a selective
decline in memory, deficits in attention, and personality
changes;

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 Alzheimer’s Disease
• Its intermediate stages are marked by confusion, irritability,
anxiety, and deterioration of speech;
• and in its advanced stages, the patient deteriorates to the
point that even simple responses such as swallowing and
controlling the bladder are difficult.
• Alzheimer’s disease is terminal.
• Because Alzheimer s disease is not the only cause of
dementia, it cannot be diagnosed with certainty on the basis
of its behavioral symptoms definitive diagnosis of Alzheimer
s disease must await autopsy.
• The two defining characteristics of the disease are
neurofibrillary tangles and amyloid plaques.
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 Alzheimer’s Disease
• Neurofibrillary tangles are threadlike tangles of protein
in the neural cytoplasm.
• Amyloid plaques are clumps of scar tissue composed of
degenerating neurons and a protein called amyloid,
which is present in normal brains in only very small
amounts.
• Although neurofibrillary tangles, amyloid plaques, and
neuron loss tend to occur throughout the brains of
Alzheimer s patients, they are more prevalent in some
areas than in others: amygdala, hippocampus.

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 Alzheimer’s Disease
• Neurofibrillary tangles are threadlike tangles of protein in
the neural cytoplasm.
• Amyloid plaques are clumps of scar tissue composed of
degenerating neurons and a protein called amyloid, which
is present in normal brains in only very small amounts.
• Although neurofibrillary tangles, amyloid plaques, and
neuron loss tend to occur throughout the brains of
Alzheimer s patients, they are more prevalent in some
areas than in others: amygdala, hippocampus.
• Alzheimer s disease has a major genetic component.
• There is currently no cure for Alzheimer s disease

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THE END 

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 NEXT TOPIC
• Brain Lateralization, Language
and Split Brain

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