• Neurology

    Aphasia

    Terminology Dysarthria = problem with slurring of speech Articulation defects = problems with motor control of the mouth Anomia = inability to name things, a key finding in almost all aphasias. Mild anomia is difficulty naming objects that are less commonly used in speech. Severe anomia is difficulty naming everyday objects. Anosognosia = person is unaware that they have a neurologic deficit, typically due to a lesion in the non-dominant hemisphere Apraxia = person is unable to carry out a learned motor task but their motor, sensory and coordination is preserved – so they should be able to perform the task. Agnosia = person is unable to recognize objects Prosopagnosia…

  • Neurology

    Nervous System Hemorrhage

    Extraparenchymal –> outside of brain Caput succedaneum = blood above the glea aproneurotica but under the scalp Subgleal hemorrhage = blood under the glea aproneurotica and between the skull opening Cephalohematoma = blood under the upper periosteum and above the skull Epidural hematoma = blood under the lower periosteum and above the dura mater Subdural hematoma = blood under the dura mater and in the arachnoid/ above the pia mater. Intraparenchymal –> into brain Subarachnoid hemorrhage = bleeding under the arachnoid membrane but above the pia mater. Cerebral lobe (cortical) hemorrhage = bleeding can be in the dominant and non-dominant frontal lobes, parietal lobes, and temporal lobes or the occipital…

  • Neurology

    Intraventricular Hemorrhage

    The germinal matrix is a region in the developing fetus that is located next to the ventricles (periventricular) and gives rise to neurons and glial cells. It is highly vascularized with fragile capillaries that can easily rupture. This region involutes by 32 weeks of gestation. There is supporting structures around it that develop and protect it. In premature babies born before 32 weeks, the germinal matrix has not involuted putting them at risk for rupture of the fragile capillaries leading to intraventricular hemorrhage (IVH). In very low birth weight newborns, <1500g, the risk of germinal matrix capillary rupture is also increased. The blood coagulates and can be easily visualized with…

  • Alzheimer's disease - elderly man with family
    Neurology

    Alzheimer Disease

    Alzheimer’s disease is the most common cause of dementia (now called major neurocognitive disorder) affecting as many as 5.8 million Americans in 2020 and this number is expected to triple to nearly 14 million by 2060. Pathophysiology of Alzheimer’s Disease Alzheimer’s disease is a neurodegenerative condition that occurs as a result of a buildup of amyloid protein in beta-pleated sheets along with tau protein. Pathology will reveal neuritic plaques, neurofibrillary tangles of tau protein, and extra-cellular deposition of amyloid beta-proteins. The brain in Alzheimer’s disease shows several changes including enlargement of ventricles, shrinkage of cerebral cortex and shrinkage of the hippocampus. One area of the brain that degenerates in Alzheimer’s…

  • Neurology,  Uncategorized

    Memory Disorders

    Terminology Declarative memory: Semantic declarative memory:remembering facts e.g. numbers and areas of knowledge e.g. language Episodic declarative memory: remembering the time and place Procedural memory: remembering how to do things e.g. ride a bicycle Short term memory: recent memory of events e.g. what you had for breakfast Immediate short term memory: Being able to recall a fact just told to you e.g. repeat the following phone number. Long term memory: remembering something from your childhood Aphasia: impaired language/ communication. Expressive aphasia (Broca’s): impaired language fluency, and repetition, normal comprehension Receptive aphasia (Wernicke): impaired comprehension and repetition but normal fluency. Conduction aphasia: impaired repetition but normal comprehension and fluency. Global aphasia:…

  • Neurology

    Stroke and TIA

    Stroke symptoms last ≥24 hours Stroke results in permanent neurologic deficits Stroke can be due to hemorrhage (20%) or ischemia (80%) Stroke with no known cause is called cryptogenic Stroke spares the upper 1/3 of the face TIA symptoms last <24 hours TIA symptoms resolve completely TIA can only be due to ischemia (emboli or thrombus) – because hemorrhage would take >24 hours to resolve TIA does not spare the upper 1/3 of the face Artery localization The artery affected in stroke or TIA can be localized based on the symptoms. Anterior Cerebral Artery (ACA) Mainly lower extremity weakness Urinary incontinence Personality changes or psychiatric symptoms Middle Cerebral Artery (MCA)…