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NeuroAnatomyNeuroAnomolies

DaiWai M. Olson RN PhDAssociate Professor of Neurology & Neurotherapeutics

Associate Professor of NeurosurgeryUT Southwestern, Dallas TX

Editor-in-Chief, Journal of Neuroscience Nursing

Case # 1

17 year old white femalewith sustained

loss of consciousness

ODDS RatioWhat are the odds of a specific outcome given that the patient has been exposed to a specific variable.

95% CI = we are 95% sure that the real value is within this range?

Does the 95% Confidence interval contain the value of 1.0?

OR 1.5 (95%CI = 1.3 – 1.6)

OR 1.5 (95%CI = 0.9 – 2.1)

Significant

NOT significant6

What is sleep? - What is Awake?

a SYSTEM. It is not

one little piece of the

brain.

Key knowledge is that

this has a feedback

loop.

The Ascending Reticular Activating System

Is first and foremost -

. . . The A.R.A.S.

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Artery Of

Percheron

Thalamic Stroke

Can result in COMA

Case # 2

184 y.o. male

Profound Aphasia

Born 1830 – Died 2014

Tan Tan

• 30 y.o. male admitted to Bicetre (1830)

• Loss of speech “Tan”

• Age ~40 – right arm weakness

• Died at age 51

Aphasia

Case # 3

19 year old Atlantian femalesudden onsetloss of speech

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19 y.o. Female

Converted to vegan diet(most likely peer pressure)

High Salt intake (typical teenager)

Presents with mutism / aphasiaThere are a fair number of patients with posterolateral thalamic hemorrhage who have transcortical aphasia . . . . (Ariel) . . . Especially - those with left-sided lesions

SpeechBroca’s area, and Wernicke’s area are connected by the Arcuate Fasciculus

Case # 4

~60 year old white femaleErratic Behavior

Aphasic

Miss D

Female born in 1958

Born in Louisiana. . .

. . . but travels a lot

Mother was a speech therapist

PFO (patent foramen ovale)

Atrial Fibrillation

Anterior cerebral arteryThe anterior cerebral artery extends up

from the carotid artery.We typically talk about 3 segments

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Anterior cerebral arteryThe anterior cerebral artery extends up

from the carotid artery.We typically talk about 3 segments

• A1 originates from the ICA and extends to the anterior communicating artery

• A2 goes from the anterior communicating artery to the callosomarginal artery

• A3 starts at the callosmarginal artery

Amygdala

Typically,

Memory = Hippocampus

Amygdala = emotion

BUT

The amygdala is thought to be required for

memory consolidation

Dory could not get her

short term memories into long term storage

The effect on memory was moderated by emotion

Case # 5

22 month old female

ptosis and cognitive delay

Baby D

22 Month old FemalePresents with severe ptosis

Mild cognitive delayEmotionally labile

RememberHomunculus

&The motor

strip

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Case # 6

34 year old female

Unilateral Vision Loss

Mrs. J. R.

Mrs. J.R. is an actress / singer who had sudden onset unilateral vision loss.

The vision loss was permanent and she determined to live a normal life by cosmetically covering up for her unilateral blindness.

Retinal Artery Stroke

Shortly after celebrating her 34th birthday, Jessica experienced Amaurosis fugaxfollowed by unlateral blindness in her right eye.

Jessica describes this as a painless event while she was working on a movie.

Her carotid artery disease was later linked to poorly controlled diabetes (Mrs. J.R. states “sugar is a way of life for everyone I know”).

Amaurosis fugax•Temporary loss of sight

•Painless

•Described as a shade coming down over one’s vision

BecauseRetinal Artery Occlusion is often temporary

A.F. is often unreported

Stroke

We have made a lot of progress in stroke care.

We are saving lives every day

. . . But not everybody survives . . .