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BRAIN DAMAGE AND NEUROPLASTICITY are a common type of abdomen, or brain, eye, or nervous
malignant tumor. chest. system.
Neuroplasticity – the ability of the nervous system to change its activity in response to
intrinsic or extrinsic stimuli by reorganizing its structure, functions, or connections after EARLY WARNING SIGNS OF CANCER
injuries, such as a stroke or traumatic brain injury (TBI). CHANGE IN BOWEL OR BLADDER
A LESION THAT DOES NOT HEAL
What are the warning signs and symptoms of cancer?
• CAUTION UP
UNUSUAL BLEEDING OR DISCHARGE
What is the common term of cerebrovascular disorder? THICKENING OR LUMP
• STROKE INDIGESTION OR DIFFICULTY SWALLOWING
What are the categories of cerebrovascular disorder?
• ISCHEMIC AND HEMORRHAGIC
OBVIOUS CHANGES IN WART OR MOLE
NAGGING COUGH OR PERSISTENT HOARSENESS
Brain Tumor/Neoplasm – a mass or growth of abnormal cells in your brain. There are three UNEXPLAINED WEIGHT LOSS
main types of tumors: Benign, Premalignant, and Malignant
PERNICIOUS ANEMIA
Benign vs. Malignant Tumors
Benign (not cancer) tumor cells grow only Malignant (cancer) cells invade neighboring Brain tumors can cause both physical and mental symptoms. The symptoms can differ
locally and cannot spread by invasion or tissues, enter blood vessels, and metastasize depending on the type, location, and stage of the tumor.
metastasis. (spread) to different sites.
Cerebrovascular Disorder: Stroke
Types of Tumors It is an umbrella term that refers to any functionally abnormality of the CNS that occurs when
Carcinoma Sarcoma Germ cell tumor Blastoma the normal blood supply to the brain is disrupted. It has two major categories: Ischemic and
(malignant) Hemorrhagic
These tumors These These These
form from epithelial tumors start in tumors develop in tumors form from Different events may have different effects, but common symptoms include:
cells, which are present connective tissue, the cells that embryonic tissue or 1. a severe and sudden headache
in the skin and the tissue such as cartilage, produce sperm developing cells. 2. paralysis of one side of the body, or hemiplegia
that covers or lines the bones, fat, and and eggs. They Blastomas 3. weakness on one side, also known as hemiparesis
body’s organs. nerves. They usually occur in are much more 4. confusion
Carcinomas originate in the the ovaries or common in children 5. difficulty communicating, including slurred speech
can occur in the cells outside the testicles, but they than in adults. 6. losing vision on one side
stomach, prostate, bone marrow. may also appear in They can 7. loss of balance
pancreas, lung, liver, the brain, lead to tumors in the 8. becoming unconscious
colon, or breast. They
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If you act FAST, treatment is possible. Timing is key. The faster you act; the less likely disability Angiogram – a scan that shows blood flow through arteries or veins, or through the heart,
or death will occur. using X-rays, computed tomography angiography (CTA) or magnetic resonance angiography
Face looks uneven (MRA).

• Ask them to smile. Does one side of the face droop?

Arm hanging down Hemorrhagic Stroke / Cerebral Hemorrhage
Brain bleeding occurs when a cerebral blood vessel ruptures and blood seeps into the
• Ask them to raise both arms. Does one arm drift downward?
surrounding neural tissue and damages it.
Speech slurred
• Ask them to repeat a phrase. Does the speech sound odd?
Causes of bleeding in the brain
Time is vital 1. Intracerebral hemorrhage
• If any of these signs are present, call emergency services right away. 2. Arteriovenous malformations
3. Subarachnoid hemorrhage
Ischemic Stroke / Cerebral Ischemia
It is a disruption of the blood supply to an area of the brain. The three main causes of cerebral Traumatic Brain Injury
ischemia are: Thrombosis, Embolism, and Arteriosclerosis
Clinical Manifestations of Brain Injury
Thrombosis occurs when a blood clot forms either in an artery or vein. The clot is known as a 1. Altered level of consciousness
thrombus. 2. Confusion
3. Altered or absence of reflex
An embolism is a blocked artery caused by a foreign body, such as a blood clot or an air 4. Sudden onset of neurologic deficits
bubble. 5. Changes in vital signs
6. Vision and hearing impairment
Arteriosclerosis is a type of vascular disease where the blood vessels carrying oxygen away 7. Sensory dysfunction
from the heart (arteries) become damaged from factors such as high cholesterol, high blood 8. Spasticity
pressure, diabetes, and certain genetic influences. 9. Headache
10. Vertigo
Signs and Symptoms 11. Seizures
1. Numbness or weakness of the face, arm, or leg especially on one side of the body
2. Confusion or change in mental status Types of Head Injury
3. Trouble speaking or understanding speech 1. Closed Head Injuries
4. Visual disturbances 2. Penetrating Brain Injury
5. Difficulty walking, dizziness, or loss of balance
6. Sudden severe headache Primary brain injury – refers to the sudden and profound injury to the brain that is
considered to be more or less complete at the time of the impact. This happens at the time
of the car accident, gunshot wound, or fall.
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5. Loss of automatic movements – may have a decreased ability to perform

Secondary brain injury – refers to the changes that evolve over a period of hours to days
after the primary brain injury. It includes an entire series of steps or stages of cellular, chemical,
tissue, or blood vessel in the brain that contribute to further destruction of brain tissue.
Infections of the Brain
unconscious movements, including blinking, smiling, or swinging your arms when
you walk.
6. Speech changes – may speak softly, quickly, slur or hesitate before talking. Your
speech may be more of a monotone rather than have the usual inflections.
7. Writing changes – may become hard to write, and your writing may appear small.

It can be caused by viruses, bacteria, fungi, or occasionally, protozoa or parasites.

Huntington’s disease – a chronic progressive, hereditary disease of the nervous system that
results in progressive involuntary choreiform movement and dementia. It has a broad impact
Syphilis
on a person's functional abilities and usually results in movement, thinking (cognitive) and
• Stage1
psychiatric disorders.
Painless sore forms on genitals, rectum, or mouth
• Stage 2
Multiple Sclerosis – a condition that can affect the brain and spinal cord, causing a wide
Painless sore heals and skin rash forms.
range of potential symptoms, including problems with vision, arm or leg movement,
sensation, or balance.
Neurotoxins
Are substances which alter the function of the nervous system by damaging brain cells or the
The signs and symptoms may vary depending on the location of lesions. The
nerves which carry signals around the body.
primary reported signs and symptoms are:
1. Fatigue
Neurological Disorders 2. Depression
3. Weakness
Epilepsy – a group of syndromes characterized by recurring seizures.
4. Numbness
5. Difficulty in coordination
Seizures – a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in
6. Loss of balance
your behavior, movements, or feelings, and in levels of consciousness.
7. Pain
8. Visual disturbance such blurring vision to loss of vision
Parkinson’s disease – a slowly progressing neurological movement’s disorder that eventually
leads to disability. The degenerative or idiopathic form is the most common.
Alzheimer’s disease – a progressive disorder. It is a brain disorder that slowly destroys
memory and thinking skills.
Clinical Manifestations
1. Tremor – or shaking, usually begins in a limb, often your hand or fingers.
2. Rigidity – a muscle stiffness may occur in any part of your body.
3. Bradykinesia – slowed movement.
4. Impaired posture and balance – posture may become stooped, or you may have
balance problems because of Parkinson's disease.
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LEARNING, MEMORY, AND AMNESIA

Learning deals with how experience changes to the brain.
Memory deals with how these changes are stored and subsequently reactivated.
Process of Memory
1. Encoding – the process by which information is put into memory. It may be visual,
acoustic, or semantic. Visual encoding and acoustic encoding are self-explanatory;
they are named for the sensory modality through which they operate. Semantic
encoding refers to the general meaning of an event.
2. Storing – the process by which information is maintained in memory.
3. Retrieving – the process by which information is recovered from memory.
Three Types of Memory
1. Sensory – information from the world around us begins to be stored by sensory
memory, making it possible for this information to be accessible in the future.
2. Short Term – allows us to store and use temporary information.
3. Long Term – holds lifelong memories.
H.M.’s memory deficits were instrumental in the achievement of our current understanding of
the neural bases of memory (Corkin, 2002).
The Case of H.M., The Man Who Changed the Study of Memory
During the 11 yrs. preceding of his surgery, H.M. suffered an average of one
generalized seizure each week and many focal seizures each day.
Electroencephalography suggested that H.M.’s seizures arose from foci in the medial
portions of both of his left and right temporal lobes.
So, the decision was made to perform a bilateral medial temporal lobectomy - the
removal of the medial portions of both temporal lobes, including most of the hippocampus,
amygdala, and adjacent cortex.
LOBECTOMY – an operation in which lobe, or a major part of one, is removed from the brain.
LOBOTOMY – an operation in which a lobe, or a major part of one, is separated from the rest
of the brain by a large cut but is not removed.

Rehearsing H.M was the last patient to receive a bilateral medial temporal lobectomy- because
of its devastating amnesic effects.

selective attention is defined as “the capacity for or process of reacting to certain stimuli
selectively when several occur simultaneously.”

Amnesic Effects of Bilateral Medial Temporal Lobectomy

H.M., a man who in 1953, at the age of 27, had the medial portions of his temporal lobes
removed for treatment of a severe case of epilepsy.
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In assessing the amnesic effects of brain surgery, it is usual to administer tests of the
patient’s ability to remember things learned before and after the surgery.
Deficits on the former tests lead to a diagnosis of retrograde amnesia (backward
acting) and those on the latter tests lead to diagnosis of anterograde amnesia (forward
acting).
Anterograde amnesia is a type of memory loss that occurs when you can't form new memories.
If a patient is found to have anterograde amnesia, the next step is usually to determine
whether the difficulty in storing new memories influences:
short-term memory – storing of new information for brief periods of time while a person
attends to it.
long-term memory – storage of new information once the person stops attending to it.
In effect, H.M. became suspended in time on that day in 1953 when he regained his
health but lost his future. It was as if he was continually regaining consciousness.
Formal Assessment of H.M.'s Anterograde Amnesia: Discovery of
Unconscious Memories
DIGIT SPAN +1 TEST
It is a classic test of verbal long-term memory.
H.M.’s inability to form certain long-term memories was objectively illustrated by his
performance on the digit span +1 test.
H.M. was asked to repeat 5 digits that were read to him at 1-second intervals.
BLOCK-TAPPING MEMORY-SPAN TEST
H.M. had global amnesia – amnesia for information presented in all sensory
modalities. Milner (1971) demonstrated that H.M.’s amnesia was not restricted to verbal
material by assessing his performance on the +1 version of the block-tapping memory-span
test.
An array of 9 blocks was spread out on a board in front of H.M., and he was asked
to watch the neuropsychologist touch a sequence of them and then to repeat the same
sequence of touches.
MIRROR-DRAWING TEST
The first indication that H.M.’s anterograde amnesia did not involve all long-term
memories came from the results of mirror-drawing test (Milner, 1965).
H.M.’s task was to draw a line within the boundaries of a star-shaped target by
watching his hand in the mirror.
However, despite his improved performance, H.M. could not recall ever having
completed the task before.
INCOMPLETE-PICTURES TEST
It is a nonsensorimotor test of memory that employs five sets of fragmented
drawings. Each set contains drawings of the same 20 objects but sets differ in their degree of
completeness.
Despite his improved performance, H.M. could not recall previously performing the
task.
PAVLOVIAN CONDITIONING
H.M. learned an eye-blink Pavlovian conditioning task, albeit/although at a retarded
rate (Woodruff-Pak, 1993).
A tone was sounded just before a puff of air was administered to his eye; these trials
were repeated until the tone alone elicited an eye blink.
Two years later, H.M. retained this conditioned response almost perfectly, although
he had no conscious recollection of the training.
THREE MAJOR SCIENTIFIC CONTRIBUTIONS OF H.M.'s Case
1. By showing that the medial temporal lobes play an especially important role in
memory, H.M.’s case challenged the then-prevalent view that memory functions are
diffusely and equivalently distributed throughout the brain.
2. The discovery that bilateral medial temporal lobectomy abolished H.M.’s ability to
form certain kinds of long-term memories without disrupting his performance on
tests of short- term memory or his remote memory. H.M.’s specific problem
appeared to be a difficulty in memory consolidation (the translation of short-term
memories into long- term memories).
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3. H.M.’s case was the first to reveal that an amnesic patient might claim no recollection
of a previous experience while demonstrating memory of it by improved
performance. This discovery led to the creation of two distinct categories of long-
term memories became known as:

explicit memories or declarative memories – a conscious long-term memories.

implicit memories – long-term memories demonstrated by improved test performance

without conscious awareness.

H.M died in 2008 of respiratory failure. His real name was HENRY MOLAISON.