Clinical Neuropsychology: CHAPTER ONE
Clinical neuropsychology is a specialty area in the field of psychology that focuses on
how the brain functions within the normal individual and what happens to an individual
with brain illness or brain injury.
Questions a clinical neuropsychologist would ask themselves: Why does he behave and
think as he does?
called applied because it deals with the assessment, diagnosis and treatment of the
individuals with brain injuries or illnesses.
Experimental neuropsychology: focuses on brainbehaviour relationships within
humans and other animals. They do this by describing structures and functions, as
opposed to focusing on assessment process and the development of a treatment plan.
the term neuropsychology was first used by Sir William Osler on April 16 1913.
During that time of period, neuropsychology represented the combined interests
of many disciplines including psychologists, neurologists, psychiatrists, speech
pathologists and others interested in the relationship between the brain and
Neuropsych was ultimately related to the study of the relationship between the
brain and behavior.
Most of the subjects for the early studies were animals.
Trephination is the oldest known surgical technique in which a small piece of
bone is removed from the skull leaving a hole in the skull. The procedure has
been done for medical and religious reasons. (Neolithic period/stone age).
Verona systematically studied trephined skulls to see if there was a pattern to the
use of trephining. He looked at 750 Skulls collected from Peru and concluded that
the ancient Peruvians did trephine some children and adult women but focused
mainly on adult men. Most Trephining occurred in areas we now know as the
frontal and upper parietal regions.
Some individuals who experienced the trephining procedure and survived
probably had residual damage caused by the lack of precision in the procedure,
which may have affected multiple areas of the brain.
However, there are individuals who have undergone the procedure and was able
to function normally after.
They were thought to have been advanced in many and diverse areas but,
surprisingly, were not as advanced in their understanding of the brain.
The process of mummification could take as long as 70 days to complete.
Organs are removed from the body but not the heart.
Because, the heart is the seat of the mind and soul and the person will need it for
afterlife. Edwin Smith Surgical Papyrus: early Egyptian manuscript which described the
techniques used to treat various forms of difficulties including brain trauma.
It is one of the first accounts of brainbehaviour relationships.
A brainbehaviour relationship exists when a function of the brain is thought to
cause or influence a particular behavior.
Although the document is called Surgical papyrus, there were no indications that
actual surgery was performed.
The document gave reference to what are currently the meninges and the
The papyrus also discussed early ways to determine which patients could be
successfully treated, which patients’ status was questionable, and which patients
were too severely impaired for treatment.
Within the Edwin Smith Surgical Papyrus are accounts of 48 individuals with
physical injuries and 27 with trauma to the head.
Included, were ways to reduce intracranial hemorrhaging and the removal of
fragments of bone from the ear canal and blood clots from the sinuses.
As we recall the Egyptians still believed that illness and other maladies were
caused by various deities.
The Ebers Papyrus is often thought to contain more magical or superstitious forms
of healing than the Edwin Smith Surgical Papyrus.
The Herophilus and Erasistratus From the city of Alexandria were the first to
propose the brain as the center of reason. They provided the first accurate and
detailed description of the human brain including the ventricles.
These people completed most of their work on cadavers and also used condemned
criminals for vivisection.
Vivisection: the dissection of the body, animal or human while it is still living.
They do this with the intention that physicians could learn new facts about the
Ventricular localization hypothesis: The hypothesis that mental and spiritual
processes reside within the ventricular canals.
Cell doctrine: a term synonymous with the ventricular localization hypothesis i.e.
that the ventricles were the location of higher order mental and spatial processes.
Cerebrospinal fluid: cushions the brain within the skull, is made in the choroid
plexuses and flows through the ventricles and the subarachnoid space, the space
between the layers of the brain.
Were interested in accounts of brainbehaviour relationships.
Heraclitus along with Parmenides, were considered the most significant
philosopher of ancient Greece until Socrates and Plato.
Pythagoras, a mathematician was the first to suggest that the brain was the organ
responsible for human thought.
Brain hypothesis: the hypothesis that the brain is the source of human thought and
Follower of Pythagoras believed in natural science and Philosophy. They lived together in a communal group and followed a strict ethical code of
Hippocrates considered being the founder of modern medicine, further expanded
the understanding of the brain.
Hippocratic Oath: an agreement that Hippocrates demanded of physicians
ensuring that they would do no harm in their quest to appropriately treat their
They were the first to indicate that damage to one side of the brain affect the other
side of the brain: Contralateral control.
Hippocrates was a physician who practice holistic medicine, a belief that the
body, mind and soul must be addressed for successful treatment of the patient.
Plato, a student of Socrates and philosopher of human behavior, thought that the
soul was divided into three functions: appetite, reason, and temper, which reside
within the brain.
Plato also discussed the mindbody question.
Discussed to further explain the harmony between the mind and the body, health
However, Aristotle, a student of Plato, disagreed with him, instead believes that
the heart is the main organ of rational thought.
Cardiac Hypothesis: the heart was the originator of numerous emotions.
Galen: is considered the first experimental physiologist and physician.
Galen was a believer, similar to Aristotle, that the only valid sources of data were
He completed dissections and vivisections on animals closely resembling humans.
Humors: the belief that a balance of bodily fluids including blood, mucus, and
yellow and black bile were responsible for the functioning of the body and the
Galen believed that stroke resulted either from an accumulation of a thick cold
humor (such as phlegm or black bile) in the ventricles or from obstructions of the
flow of animal spirits.
The Middle Ages:
During the Middle Ages, there was a return to superstitious beliefs regarding the
causes of many of the difficulties people exhibited.
Aristotle’s work were rediscovered and translated and made available to an
His view were accepted as sacred and any questioning was unacceptable.
During this period of time, the church was considered the ultimate authority on all
Albertus Magnus theorized that behavior resulted from a combination of brain
structures including the cortex, the midbrain, and the cerebellum.
The works of Middle Eastern scientists and healers only became familiar to
Europeans at the end of the Middle Ages. Renaissance Europe:
begun in Italy in the mid14 century and ended during the 16 century. h
The renaissance marked the end of medieval Europe and allowed intellectual
freedom to flourish.
Surprisingly, one of the major factors in the start of the Renaissance was the
plague of the 1300s, the Black Death.
Leonardo Da Vinci conducte