Disorders of Brain Function Bonnie is a 70-year-old woman who lives alone. One evening, she felt light-headed and dizzy. When her head began to ache, she decided to take an analgesic and go to bed early. The following morning, upon awakening, she was unable to move the bed sheets with her right arm. At this point she was experiencing tingling sensations in her limbs, and she had difficulty keeping her balance. She dialed 911 for help, and by the time the ambulance arrived, she was confused and unable to articulate her words although she knew what information he was asking of her. In the hospital, she was examined and treated for ischemic stroke.
- Stroke, or brain attack, involves brain tissue injury. Describe ischemic penumbra and what factors contribute to the survival of the neurons involved. What happens if the cells of the penumbra are unable to be preserved?
- Compare and contrast hypoxia and ischemia. What condition is more dangerous to the brain? Explain your answer.
- Knowing what you do about the effects of ischemia on the brain, why would someone with ischemic stroke develop cerebral edema?
- What type of aphasia was Bonnie exhibiting when talking to her caregivers? Explain your answer.
Case Study 5
Sleep and Sleep Disorders
Jessica is six years old. Her parents recently saw her pediatrician because they were concerned about the sleeping difficulties Jessica has been having. Often she would scream out loud in her sleep. Her parents would rush to her room and find her sitting upright in bed, panting heavily in a state of panic. Jessica would not respond to her parent’s words of consolation, and the next morning she would have no memory of the incident at all. Her parents were worried about the anxiety their daughter was experiencing and asked the pediatrician what they could do about her nightmares. The pediatrician explained Jessica was likely suffering from sleep terrors and carefully described what that meant.
- What are the similarities and differences between nightmares and sleep terrors?
- What are the characteristics of motor, sensory, and autonomic function during REM sleep? What is thought to be the importance of this stage of sleep?
- Jessica’s pediatrician said that the careful management of sleep hygiene may help to decrease the incidence of her sleep terrors. What is included in an overview of the general features that demonstrate good sleep hygiene?
Case Study 6
Disorders of Thought, Emotion, and Memory
Ella is 88 years old and was living at home until very recently. Her children, who visited her regularly, noticed she was becoming more forgetful. At first, she mislaid objects, and then she began to forget her doctor’s appointments. With time, her personality changed and she became withdrawn. At home she would forget to turn off the stove or leave the kettle on until it boiled dry. After seeking advice from a gerontologist and social worker, Ella’s children placed her in a nursing home with a unit equipped for patients with Alzheimer disease.
- What is dementia? Why is Alzheimer disease based on a “diagnosis of exclusion”?
- What are the macroscopic and microscopic features of the brain that are typical in Alzheimer disease?
- One of Ella’s children brought her a new pair of slippers to wear in the nursing home. A minute after she received them, Ella could not remember the exchange and asked what they were doing on her bed. What part of the brain has largely been affected to produce this behavior, and what is the pathophysiology involved?
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