Chapter 3: Neurogenic Communication Disorders

Etiology

the underlying cause of a symptom of deficit

idiopathic

Individuals with neurogenic communication disorders may have an unknown etiology of their deficit or symptoms

site of the damage and the severity of the damage

How the damage to the nervous system manifests in deficits in communication, cognition, and behavior is determined

Cerebrovascular Accident (CVA)

•Stroke

•An interruption of blood flow to or within the brain that permanently destroys brain tissue or causes a temporary cessation of function

•Produces immediate deficits

•3^rd leading cause of death in the USA

•Stroke is a leading cause of hospital admission & long-term disability

stroke

when brain tissue is either permanently destroyed or temporarily ceases to function as  result or decreased or absent blood supply to the affected area

Anoxia

the complete lack of oxygen supply to tissue

Hypoxia

the partial loss of oxygen supply to tissue

Ischemic

•Blockage of or restriction in a blood vessel

•Most strokes are ischemic in nature

•Thrombosis, Embolus, TIA

Hemorrhagic

•Means “to bleed”

•Subarachnoid & Intracerebral Hemorrhages

Ischemic Stroke

Occurs when a blood vessel supplying blood flow to the brain becomes occluded

An occlusion in a blood vessel deprives brain tissue of the blood supply necessary for the survival of the tissue

Early warning signs:

•Loss of strength or sensation on one side of the body

•Problems with speech and language

•Changes in vision or balance

Thrombus (type of ischemic stroke)

•An occlusion that forms slowly in an artery

•Occurs when a thrombus interrupts blood flow to the brain, resulting in a stroke

•Usually is the result of atherosclerosis which is a condition in which a person has a buildup of fatty material such as cholesterol in the blood, and this material accumulates slowly over time on the walls of arteries, narrowing them and eventually restricting blood flow

Embolus (type of ischemic stroke)

•A mass, such as a blood clot, that originates in the body and travels through the vascular system is known as an embolus

•An embolic stroke occurs when an embolus formed elsewhere in the body, traves to the brain and lodges in a blood vessel, restricting or cutting off blood circulation within the brain

Transient Ischemic Attack (TIA) (type of ischemic stroke)

•Mini stroke

•A small ischemia within the brain that resolves within 24 hours

•Mild problems that resolve quickly

•Do not cause permanent deficits or life-threatening health issues

•TIAs are warning signs of a larger, more destructive stroke to come

•Multiple, recurring TIAs can cause lasting deficits over time, known as vascular dementia

Hemorrhagic Stroke

•When a blood vessel within the brain ruptures

•13% of strokes are hemorrhagic

•Occur in individuals with high blood pressure (hypertension) and often during periods of high physical activity

•Require immediate surgery to repair the broken blood vessel & to stop the bleeding

•Usually have a less chance of survival than those who experience an ischemic stroke

•Presents with a sudden & very severe headache that might be associated with nauseated & vomiting

Dangerous mechanisms

•Blood supply is interrupted

•The blood is diverted out of the broken blood vessel and pours into the brain (blood spilling outside of the circulatory system into the brain tissue)

•Continued release of blood into the brain increases intracranial pressure

•Intracranial Pressure: the pressure within the skull; the amount of pressure that is exerted on the brain

Subarachnoid Hemorrhage

A bleed that occurs between the surface of the cerebrum & the skull

Intracerebral Hemorrhage

Occurs when a blood vessel bursts within the brain itself

Aneurysm

•An abnormal stretching & ballooning of the wall of a blood vessel

•Can result from disease or hereditary factors that weaken the wall of an artery

•Hypertension and atherosclerosis can also contribute by placing above normal amounts of pressure on artery walls

•Symptoms: headache, nausea, blurred vision, seizures, loss of consciousness

•Once a cerebral aneurysm ruptures, it becomes a hemorrhagic stroke with a sudden and rapid spilling of blood into the brain

•Often occur within the Circle of Willis

•Tend to be deadly

Golden hour

refers to the first hour following stroke or TBI

Traumatic Brain Injury TBI

•When serious damage to the brain occurs as the result of an external and forceful event

•Falls, MVA, assaults

•The impact can range from a mild concussion to coma or death

•Deficits in language and cognition following TBI are many, complex, and varied

•Typically a function of which areas of the CNS and PNS were damaged and to what extent

Toxic Brain Injury

•Damage to the brain from high levels of poisonous substances in the body

•In addition to hypoxic or anoxic brain injury, if an individual survives an opioid overdose, he might also have a toxic brain injury

•Common following carbon monoxide poisoning

Neoplasm

•A brain tumor

•An abnormal growth of cells in the brain

Primary Tumor

•A tumor that originates within the brain

•Has not spread from a tumor elsewhere in the body

Secondary Tumor or Metastatic Tumor

A cancerous tumor that has spread from another part of the body to the brain

Malignant Tumor

•Brain cancer

•Life-threatening

•Can grow quickly

Spreads easily

Benign Brain Tumor

•Cannot spread to other parts of the body

•Can grow uncontrollable w/in the brain, crushing the brain against the skull & damaging healthy brain tissue

Surgical Trauma

is the collateral damage to the delicate tissues of the brain that occurs during the process of achieving the objective of the surgery

Encephalitis

•General term indicating an acute infection or inflammation of the brain or spinal cord

•Caused by a viral or bacterial infection

•Symptoms: headaches, fevers, confusion, and seizures

Human Immunodeficiency Virus (HIV)

Definition: HIV is a virus that attacks the immune system. AIDS is the most advanced stage of HIV infection.

Transmission: HIV can spread through sexual contact, infected blood, and from an infected mother to her child.

Effects on the Body: HIV weakens the immune system, making it harder for the body to fight infections and diseases.

Treatment: There is no cure for HIV, but medications can control the virus and reduce damage to the immune system.

Neurological Effects: HIV/AIDS can affect the brain and nervous system, sometimes causing NeuroAIDS or HIV-associated dementia.

CommonNeurologicalSymptoms

Learning and Memory Problems: Difficulty learning new information and remembering things

Movement Problems: Difficulty controlling large and small muscle movements.

Gait Disturbances: Problems with walking and balance.

Attention and Processing: Difficulty concentrating and processing information quickly.

Speech Problems: Difficulty speaking smoothly or fluently.

Syphilis

•Sexually transmitted disease that is highly treatable with the antibiotic penicillin and is curable

•If left untreated, symptoms progress to disease of the nervous system

Neurosyphilis

a specific variation of syphilis that affects the nervous system

•Symptoms include:

•Meningitis

•Headache

•Stiff neck

•Changes in vision

•Facial weakness

•Cognitive deficits

•Motor problems

Involvement of CNs

Poliomyelitis

Cause: Polio is caused by a virus.

Prevention: Polio can be prevented with a vaccine.

Who It Affects: It mainly affects children.

Transmission: The virus spreads through food or drinking water contaminated with infected fecal matter.

Prevalence: Polio is rare in the United States but remains a threat in some countries.

Nervous System Effects: Polio attacks motor nerves in the peripheral nervous system (PNS), which control muscle movement.

Symptoms: Polio can cause muscle weakness, paralysis, and absent reflexes.

Post-Polio Syndrome: About 25–50% of polio survivors may develop symptoms later in life, including muscle weakness, muscle pain, and fatigue.

Speech and Swallowing Problems: It can affect facial muscles used for speech and throat muscles involved in voice production and swallowing.

seizure

is a sudden abnormal level of electrical discharge in the brain

Partial

simple partial seizures

complex partial seizures

Generalized

tonic-clonic seizure (once known as the gran mal)

petit mal seizure (also known as absence attacks)

Partial Seizures

•Individuals with epilepsy most commonly experience partial seizures

•During a partial seizure, the pathologic levels of electrical activity are confined to a particular region of the brain

•Can create just about any imaginable motor, sensory, or emotional symptoms because these seizures can occur in practically any part of the brain

Simple Partial Seizure

•The seizure activity in the brain is limited to a small area in one cerebral hemisphere

•Person remains conscious

Complex Partial Seizure

•Seizure occurs over a larger section of a single cerebral hemisphere

•Creates an altered state of consciousness

•Creates changes in level of awareness or result in a dreamlike state

Generalized Seizures

•Affect the entire brain

•Associated with total loss of consciousness or awareness

•2 forms of generalized seizures:

•tonic-clonic seizure (gran mal)

•petit mal seizure (absence attacks)

Tonic-Clonic Seizure

•Manifests 2 distinct phases

•Tonic Phase:

•Individual loses consciousness

•The body stiffens as a result of muscle contractions

•Initial stage, short

•Clonic Phase:

•Individual convulses

•Displays violent twitching & shaking

•Followed by sleep

Petit Mal Seizures

•Often go undiagnosed for years

•Individual loses awareness for a few seconds

•Seems simply to stare into space before coming to

•No gross motor activity or shaking