Brain Bee Chapter 14 - Injury and Illness

primary brain tumor

originates in the brain

malignant - cancerous
benign - noncancerous

surgery required

metastatic brain tumor

cancer cells from other body parts travel through bloodstream to brain
→ lung, breast, skin, colon, kidney
surgery required

glioma

tumors arising from glial cells

glioblastoma

most common form of brain cancer
proliferation of immature glial cells

releases toxic amounts of glutamate → destroy nerve cells and cause seizures

meningioma

most common type of brain tumor
→ benign tumor arising in meninges

meninges

thing layer of tissue covering the brain

brain tumor symptoms

vary with location and size → headache, difficulties with the senses

brain tumor initial treatment

if possible without injuring nearby areas → brain surgery
craniotomy

radiation, stereotactic radiosurgery

ultrasound beams focused on tumor

brain tumor post-surgery

steroid medications to reduce swelling → alleviates symptoms such as seizures, memory problems, confusion

for cancerous brain tumors → radiation to eliminate any remaining cancer cells / chemotherapy

chemotherapy

can be delivered directly to brain tumor → after surgical removal, anticancer drugs are implanted into tumor-occupying space to dissolve into brain

brain tumor targeted treatments

treatments zero in on genes and cell mechanisms that fuel cancer cell growth →
ex: blocking blood vessel formation for glioblastomas (tumor forms strong vessel network, feeding growth)

immunotherapy

uses body’s immune system to stop tumor growth →
checkpoint inhibitors interfere with signals tumors send to inhibit immune system response to cancer

gene therapy

identifies with gene components that promote tumor growth

attaching brain tumor treatments

targeted delivery of antibodies, toxins, and growth-inhibiting molecules that attach specifically to tumor cells and interfere with growth

stem cell research for cancer

understanding normal processes that allow stems to mature will help understand cancer cells

traumatic brain injury

primarily due to car crashes
caused by bumps, blows, or jolts to the head that cause minuscule bleeds or penetrated brain tissue

mild → concussion
severe → brain bruises, bleeding, tissue cuts, nerve damage, nerve cell death

CT

computerized tomography

MRI

magnetic resonance imaging

CTE

chronic traumatic encephalopathy → progressive degenerative brain disease

caused by repeated concussions and other brain trauma, including a buildup of abnormal proteins

symptoms: memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, dementia

treatment for pressure inside skull

removing water fluid from injured and inflamed brain tissue
caused by severe TBI

if fluid removal and medications fail to decrease pressure, part of skull can be drilled open or removed

brain bruising

caused by severe TBI
might cause blood to leak from vessels → toxic to brain cells

increases pressure & reduces critical blood flow

in extreme cases → can contribute to post-traumatic epilepsy

post-traumatic epilepsy

seizure disorder occurring after a TBI

TBI long term treatment

physical and occupation therapy to help regain lost functions (speech, movement)
medications can be used to treat other symptoms → pain, seizures, muscle spasms, sleep disorders, depression anxiety

SCI

spinal cord injuries
damage nerve cells, cause disability → varying degrees of paralysis

only approved treatment → methylprednisolone

methylprednisolone

only approved treatment for spinal cord injury
reduces damage to nerve cells and decreases inflammation near site

rehabilitation

for SCI, focuses on physical therapy to strengthen muscles and improve mobility

occupational therapy

focuses on enhancing fine motor skills

HAND

HIV-associated neurocognitive disorders

causes mental problems → concentration, memory, coordination, decision making issues / AIDS dementia

also associated with antiretroviral treatments

MRI and CT scans show brain shrinkage → loss of nerve cells, white matter abnormalities, damage to cellular structures, inflammation

ARV cocktails

3+ antiretroviral treatments can reduce incidence of AIDS dementia
can also reverse brain abnormalities from HIV

peripheral neuropathy

injury to the nerves of extremities causing discomfort (tingling and burning to severe pain)
commonly developed by people with HIV
ARVs can cause the neuropathy / make them more frequent and serious

ARVs

antiretroviral drugs for treatment

AIDS cannot be cured, HIV makes infection and cancers more common → ARVs reduce incidence of this + other neurological problems

MS

multiple sclerosis
inflammatory disease of CNS

immune system attacks its own CNS, including brain, spinal cord, optic nerves → targets the myelin sheath
damages myelin and cells form lesions (look like sclerosis)

= damages signal transmission in white (myelin) or gray (everything else) matter

MS genetics

cause is unknown
genetic factor involved, more common in temperate climates and caucasians

MS symptoms

include numbness, clumsiness, blurred vision

slurred speech, weakness, pain, loss of coordination, uncontrollable tremors, loss of bladder control, memory loss, etc.

vary based on where MS acts

relapsing-remitting MS

flare-ups of symptoms followed by complete or partial remission of symptoms

primary-progressive MS

progressive worsening of symptoms

secondary-progressive MS

relapsing-remitting disease transitions into progressive

active vs inactive MS

presence or absence of new areas of inflammation, seen on MRI scans

stable MS = symptoms are stable and no activity appears on MRI scans

MS treatment

no cure
medications help control inflammation and immune system attacks in relapsing-remitting MS
steroid drugs (glucocorticoids) reduce inflammation & shorten acute attacks

some symptom therapies and medications

chronic pain

pain that persists, commonly in back, headache, or migraine

local anesthetics

temporarily block pain receptors
→ procaine (Novocain) and lidocaine

painkillers

4 types: aspirin & NSAIDs,
opioids,
antiepileptic agents, (gabapentin)
and antidepressants (amitriptyline)

NSAIDs

nonsteroidal anti-inflammatory drugs
ex: ibuprofen, naproxen
inhibit substances that trigger synthesis of pro-inflammatory and pain-producing chemicals (prostaglandins)

effective for post-op pain and inflammatory pain like arthritis,
useful for treating mild to moderate pain (headaches, sprains, toothache)

opioids

used for severe pain
mild = codeine
more intense = morphine

attach to receptors on nerve cells directly

antiepileptic and antidepressant drugs for pain

generally for nerve pain resulting from injury to nervous system
(neuropathy can be caused by high blood sugar, viruses, etc.)

opioid receptors

concentrated in spinal cord → morphine and other opioids injected into cerebrospinal fluid (CSF) around spinal cord

prostaglandins

increases pain sensitivity
aspirin blocks prostaglandin production → prevents pain

opiate drugs block pain signals

stroke

interruption in blood flow to brain due to a ruptured blood vessel or blood clot
risk factors: obesity, physical inactivity, heart disease, genetics

causes nerves to begin to die and free radicals to escape → effects depend on location of stroke

tPA

treatment for stroke
tissue plasminogen activator (tPA) → breaks down clots and opens blocked blood vessels , can restore circulation before oxygen loss causes permanent damage

within 3 hours → limits brain damage

anticoagulants

treatment for stroke
reduce likelihood of clots forming elsewhere, preventing future strokes