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Neurological Disorders

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 = infiltrating

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Neurological Disorders

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  1. 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

  2. Types of Tumors Malignant - cancerous = infiltrating Benign - noninfiltrating (encapsulated) Gliomas (60%) Glioblastoma - worst Astrocytoma (70%) (same etiology - just severity really) Meningioma Metastatic carcinoma (35%) - skin, lung, breast, prostrate

  3. Treatment - neuro-oncology Surgery craniotomy Radiosurgery (radiation treatment) - goal - tumor only Chemotherapy (less in brain cases) - drugs taken up my tumor cells - blood-brain barrier

  4. Neurological Disorders Cerebrovascular Accidents Trauma Infectious Diseases Degenerative Disorders

  5. Stroke - cerebrovascular accidents Ischemic (80%) thrombus - 50% embolus - 30% TIA infarct Hemorrhage (20%) intracerebral - 14% subarachnoid - 6% hypertension, aneurism, AVM

  6. 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

  7. Psychoactive Drugs Psychedelics Phencyclidine - PCP or angel dust - ketamine is similar - analgesic- amnesiac- anesthestic (powerful) - NMDA receptor - antagonist very good amnesiac - prevent Ca influx and cell death from stroke?

  8. 3401

  9. Rostral Olfactory bulb Anterior cerebral artery Optic nerves (cut off) Internal carotid artery Middle cerebral artery Temporal lobe End of temporal lobe removed Pituitary gland Mammiliary bodies Pons Posterior cerebral artery Medulla Basilar artery Cerebellum Vertebral artery caudal

  10. 3402

  11. Each of the three major arteries of the cerebral hemispheres- the anterior, middle, and posterior- provides blood to a different region of the cerebrum.

  12. 3403

  13. 3416

  14. 3417 - ischemic infarct Mid Cerebral - 24hr, 72hr

  15. 3418 - cerebellar

  16. 3419 - hemorrhage - basal ganglia

  17. 3423 - left AVM

  18. 3424 - AVM - acute, 2yrs

  19. 3425 - AVM

  20. 3426 - hypertensive - excess water & watershed lesions- eclampsia like

  21. 34N27

  22. 34N28 - thrombophlebitis

  23. 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)

  24. 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

  25. Seizure Disorders (epilepsy) Sudden excessive activity of cerebral neurons

  26. Seizure Disorders Generalized Tonic-clonic (grand mal) Absence (petit mal) Atonic (loss of muscle tone) Partial Simple (normal consciousness) localized (partial) motor Motor seizure Sensory Psychic Autonomic Complex (altered conciousness) automatisms

  27. Seizure Disorders Generalized Tonic-clonic (grand mal) Absence (petit mal) Atonic (loss of muscle tone) Partial Simple (normal consciousness) localized (partial) motor Motor seizure Sensory Psychic Autonomic Complex (altered conciousness)

  28. Seizure Disorders Generalized Tonic-clonic (grand mal) Absence (petit mal) Atonic (loss of muscle tone) Partial Simple (normal consciousness) localized (partial) motor Motor seizure Sensory Psychic Autonomic Complex (altered conciousness) automatisms

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