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PSY346 Chapter 7.doc

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Gary Kraemer

PSY346 Chapter 7-Traumatic and Chronic Brain Damage neural reserve: brain’s capacity based on the formation of neural processes and complex connections influenced by prior experiences -Australian researchers investigated whether one’s neural reserve is influenced by preinjury behaviour that both diminished and enhances neural health -Researchers found that the strongest factors predicting recovery were higher levels of intelligence and education (also known as “cognitive reserves”) TBI: traumatic brain injury, significant tissue damage -may result from exogenous forces-falling on a hard surface -may result from endogenous forces- stroke -reserved for brain injuries caused by an external physical source -loss of critical neuronal circuits threatens our memories, passions, our problem solving abilities -Book “The Brain that Changes Itself”-Doidge-discussed Paul Bach-y-Rita whose ideas about the “plastic” nature of the brain changed dramatically after his father had a stroke -introduced “polysensory” -TBI is a common condition 50,000-80,000 deaths and 235,000 hospitalizations each year -approx 1.5 million head injuries occur each year • What are the general characteristics of individuals at highest risk for TBI? -young individuals, ages 15-24 being the most vulnerable -individuals over 64 years -males are a higher risk group than females -when a person has been consuming alcohol -being in a lower socioeconomic -automobile, motorcycle, bicycle, watercraft, aircraft -participation in sports Primary Effects -brain lesions occur when an object penetrates the skull and brain in some manner -tissue damage -unrestricted movement of the head results in the shearing of brain tissue (axon shearing) often leading to subdural hematoma (a localized collection of clotted blood and accompanying increased pressure in the brain) epidural hematoma: collection of blood between the dura mater and the skull Contusion: a bruise in the brain due to brain trauma-resulting in damage to the brain’s circulatory system such as hematomas -in approx 96% of fatal brain injury cases, contusions and lacerations on the surface of the brain have been observed Secondary Factors ionic flux: altered intracellular concentrations of several ions such as decreased magnesium and potassium and increased calcium -neurons in ionic flux require energy to maintain homeostatic functioning or death will be imminent hyperglycolysis: an excessive breakdown of existing glucose into energy sources, so that homeostatic levels can be achieved once again -increase in the extracellular excitatory amino acids glutamate and aspartate -pH changes persist for about a day following the trauma -Blood brain barrier may become impaired -damaging effects persist long after the actual injury Treatment and Recovery Glasgow Coma Scale (GCS): a standard scale, designed to provide a reliable assessment of consciousness following brain trauma -various scores are assigned to functions -between 13 and 15-mild TBI -9-13-moderate TBI -less than 9-severe TBI -CT scan is used to confi
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